Perioperative Pain Management After Primary Palate Repair : A 3-Surgeon Retrospective Study
OBJECTIVE: Pain management strategies following palatoplasty vary substantially. Despite efforts to reduce narcotic utilization, specific analgesic regimens are typically guided by surgeon preference. Our aim was to define analgesic variables that affect postoperative narcotic use and time to resumption of oral intake.
DESIGN: This is a retrospective review from 2015 to 2018.
PATIENTS: Nonsyndromic patients undergoing primary palate repair.
MAIN OUTCOMES MEASURES: Analgesic variables included: local anesthetic, pterygopalatine ganglion nerve block, palatal pack, and postoperative use of ketorolac, dexamethasone, and nursing-controlled analgesia (NCA) opioid dosing. Proxy measures for pain included time to resumption of oral intake and morphine equivalence (mg/kg/h) administered.
RESULTS: Veau phenotypes for the 111 patients included were: I (28%), II (19%), III (33%), IV (16%), and submucous (4%). Age, weight, local anesthetic, and postoperative use of ketorolac, dexamethasone, and palatal pack had no effect on either proxy measure (P > .05). Postoperative narcotic usage was significantly lower in patients who had an intraoperative suprazygomatic peripheral nerve block and significantly higher when NCA was utilized (P < .05). Neither variable had a significant impact on time to resumption of oral intake (P > .05).
CONCLUSION: Several perioperative analgesic strategies lead to comparable postoperative consumption of narcotic and time to resume oral intake. The authors advise careful consideration of NCA due to the potential for increased narcotic utilization that we found in our institution. Based on our promising findings, further studies are warranted to assess risks, benefits, and costs of performing peripheral nerve blocks at the time of palatoplasty.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:60 |
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| Enthalten in: |
The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association - 60(2023), 5 vom: 01. Mai, Seite 577-585 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Ganske, Ingrid M [VerfasserIn] |
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| Links: |
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| Themen: |
7S5I7G3JQL |
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| Anmerkungen: |
Date Completed 14.04.2023 Date Revised 30.04.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1177/10556656221075932 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM341704199 |
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| 100 | 1 | |a Ganske, Ingrid M |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Perioperative Pain Management After Primary Palate Repair |b A 3-Surgeon Retrospective Study |
| 264 | 1 | |c 2023 | |
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| 500 | |a Date Completed 14.04.2023 | ||
| 500 | |a Date Revised 30.04.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a OBJECTIVE: Pain management strategies following palatoplasty vary substantially. Despite efforts to reduce narcotic utilization, specific analgesic regimens are typically guided by surgeon preference. Our aim was to define analgesic variables that affect postoperative narcotic use and time to resumption of oral intake | ||
| 520 | |a DESIGN: This is a retrospective review from 2015 to 2018 | ||
| 520 | |a PATIENTS: Nonsyndromic patients undergoing primary palate repair | ||
| 520 | |a MAIN OUTCOMES MEASURES: Analgesic variables included: local anesthetic, pterygopalatine ganglion nerve block, palatal pack, and postoperative use of ketorolac, dexamethasone, and nursing-controlled analgesia (NCA) opioid dosing. Proxy measures for pain included time to resumption of oral intake and morphine equivalence (mg/kg/h) administered | ||
| 520 | |a RESULTS: Veau phenotypes for the 111 patients included were: I (28%), II (19%), III (33%), IV (16%), and submucous (4%). Age, weight, local anesthetic, and postoperative use of ketorolac, dexamethasone, and palatal pack had no effect on either proxy measure (P > .05). Postoperative narcotic usage was significantly lower in patients who had an intraoperative suprazygomatic peripheral nerve block and significantly higher when NCA was utilized (P < .05). Neither variable had a significant impact on time to resumption of oral intake (P > .05) | ||
| 520 | |a CONCLUSION: Several perioperative analgesic strategies lead to comparable postoperative consumption of narcotic and time to resume oral intake. The authors advise careful consideration of NCA due to the potential for increased narcotic utilization that we found in our institution. Based on our promising findings, further studies are warranted to assess risks, benefits, and costs of performing peripheral nerve blocks at the time of palatoplasty | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a nonsyndromic cleft palate | |
| 650 | 7 | |a Anesthetics, Local |2 NLM | |
| 650 | 7 | |a Ketorolac |2 NLM | |
| 650 | 7 | |a YZI5105V0L |2 NLM | |
| 650 | 7 | |a Analgesics, Opioid |2 NLM | |
| 650 | 7 | |a Analgesics |2 NLM | |
| 650 | 7 | |a Narcotics |2 NLM | |
| 650 | 7 | |a Dexamethasone |2 NLM | |
| 650 | 7 | |a 7S5I7G3JQL |2 NLM | |
| 700 | 1 | |a Langa, Olivia C |e verfasserin |4 aut | |
| 700 | 1 | |a Cappitelli, Alex T |e verfasserin |4 aut | |
| 700 | 1 | |a Nuzzi, Laura C |e verfasserin |4 aut | |
| 700 | 1 | |a Staffa, Steven J |e verfasserin |4 aut | |
| 700 | 1 | |a DiTullio, Nancy |e verfasserin |4 aut | |
| 700 | 1 | |a Fullerton, Zoe |e verfasserin |4 aut | |
| 700 | 1 | |a Alrayashi, Walid |e verfasserin |4 aut | |
| 700 | 1 | |a Meara, John G |e verfasserin |4 aut | |
| 700 | 1 | |a Rogers-Vizena, Carolyn R |e verfasserin |4 aut | |
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