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Non-opioid analgesics and post-operative pain following transoral robotic surgery for oropharyngeal cancer

Published online by Cambridge University Press:  10 January 2022

K M Van Abel ,
A B Sauer Open the ORCID record for A B Sauer [Opens in a new window] ,
S C Kruthiventi ,
T N Weingarten ,
D B Noel ,
D L Price ,
J L Kasperbauer ,
J R Janus ,
K D Olsen  and
E J Moore
K M Van Abel*
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Rochester, Minnesota, USA
A B Sauer
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Rochester, Minnesota, USA
S C Kruthiventi
Affiliation:
Department of Anesthesiology, Division of Pain Medicine, Mayo Clinic School of Medicine, Rochester, Minnesota, USA
T N Weingarten
Affiliation:
Department of Anesthesiology, Division of Pain Medicine, Mayo Clinic School of Medicine, Rochester, Minnesota, USA
D B Noel
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Rochester, Minnesota, USA
D L Price
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Rochester, Minnesota, USA
J L Kasperbauer
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Rochester, Minnesota, USA
J R Janus
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Rochester, Minnesota, USA
K D Olsen
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Rochester, Minnesota, USA
E J Moore
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Rochester, Minnesota, USA
*
Author for correspondence: Dr Kathryn M Van Abel, Department of Otolaryngology – Head and Neck Surgery, Mayo Clinic School of Medicine, 200 First St SW, Rochester, Minnesota55905, USA E-mail: vanabel.kathryn@mayo.edu Fax: +1 507 284 8855
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Abstract

Objective

To investigate associations between multimodal analgesia and post-operative pain among patients undergoing transoral robotic surgery for oropharyngeal squamous cell carcinoma.

Methods

Records of patients who underwent surgery from 5 September 2012 to 30 November 2016 were abstracted. Associations were assessed using multivariable analysis.

Results

A total of 216 patients (mean age of 59.1 years, 89.4 per cent male) underwent transoral robotic surgery (92.6 per cent were human papilloma virus positive, 87.5 per cent had stage T1–T2 tumours, and 82.9 per cent had stage N0–N1 nodes). Gabapentin (n = 86) was not associated with a reduction in severe pain. Ibuprofen (n = 72) was administered less often in patients with severe pain. Gabapentin was not associated with increased post-operative sedation (p = 0.624) and ibuprofen was not associated with increased bleeding (p = 0.221). Post-operative opioid usage was not associated with surgical duration, pharyngotomy, bilateral neck dissections, tumour stage, tumour size, subsite or gabapentin.

Conclusion

Scheduled low-dose gabapentin was not associated with improved pain control or increased respiratory depression. Ibuprofen was not associated with an increased risk of bleeding and may be under-utilised.

Keywords

AnalgesicsNon-NarcoticRobotic Surgical ProceduresOropharyngeal Neoplasms
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 136 , Issue 6 , June 2022 , pp. 527 - 534
Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Dr K Van Abel takes responsibility for the integrity of the content of the paper

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