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Factors Associated With the Use of Postoperative Analgesics in Patients Undergoing Direct Microlaryngoscopy.

Abstract Morbidity associated with suspension laryngoscopy has been well documented. However, standard of care with regard to postoperative analgesia has not been described, and anecdotal evidence suggests wide variability with regard to postoperative narcotic and non-narcotic recommendations. We sought to quantify the postoperative course following suspension microlaryngoscopy by relating patient-based and intraoperative measures with analgesic use.
PMID
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Authors

Mayor MeshTerms

Analgesics

Laryngoscopy

Pain, Postoperative

Keywords

Friedman tongue position

analgesia

body mass index

direct laryngoscopy

narcotic

phonomicrosurgery

suspension laryngoscopy

voice

Journal Title the annals of otology, rhinology, and laryngology
Publication Year Start




PMID- 28397564
OWN - NLM
STAT- MEDLINE
DA  - 20170411
DCOM- 20170418
LR  - 20170418
IS  - 1943-572X (Electronic)
IS  - 0003-4894 (Linking)
VI  - 126
IP  - 5
DP  - 2017 May
TI  - Factors Associated With the Use of Postoperative Analgesics in Patients
      Undergoing Direct Microlaryngoscopy.
PG  - 375-381
LID - 10.1177/0003489417693862 [doi]
AB  - OBJECTIVE: Morbidity associated with suspension laryngoscopy has been well
      documented. However, standard of care with regard to postoperative analgesia has 
      not been described, and anecdotal evidence suggests wide variability with regard 
      to postoperative narcotic and non-narcotic recommendations. We sought to quantify
      the postoperative course following suspension microlaryngoscopy by relating
      patient-based and intraoperative measures with analgesic use. METHODS: Body mass 
      index (BMI), Friedman tongue position (FTP), and Mallampati scores as well as
      laryngoscope type, number of attempts required for optimal visualization, and
      suspension time were documented in 50 consecutive patients undergoing routine
      suspension microlaryngoscopy. Postoperative symptoms and analgesic use was
      queried on postoperative days 1, 3, and 10. RESULTS: In this cohort, 62.5%
      employed postoperative analgesia. However, only 20% required narcotics. No
      difference in suspension time was identified in those taking analgesics (33.0 vs 
      37.3 minutes, P = .44). In addition, no relationship between procedure type and
      the need for analgesia was noted. The majority of patients (76%) described sore
      throat persisting for 3 postoperative days; 36% reported sore throat persisting
      beyond postoperative day 3. CONCLUSIONS: The majority of patients undergoing
      microlaryngoscopy reported discomfort, but symptoms were largely ameliorated with
      over-the-counter analgesics. Routine prescription of narcotics following routine 
      suspension laryngoscopy may be unnecessary.
FAU - Taliercio, Salvatore
AU  - Taliercio S
AD  - 1 NYU Voice Center, Department of Otolaryngology-Head and Neck Surgery, New York 
      University School of Medicine, New York, New York, USA.
AD  - 2 ENT and Allergy Associates, New York, New York, USA.
FAU - Sanders, Brian
AU  - Sanders B
AD  - 1 NYU Voice Center, Department of Otolaryngology-Head and Neck Surgery, New York 
      University School of Medicine, New York, New York, USA.
FAU - Achlatis, Stratos
AU  - Achlatis S
AD  - 1 NYU Voice Center, Department of Otolaryngology-Head and Neck Surgery, New York 
      University School of Medicine, New York, New York, USA.
FAU - Fang, Yixin
AU  - Fang Y
AD  - 3 Department of Population Health, New York University School of Medicine, New
      York, New York, USA.
FAU - Branski, Ryan
AU  - Branski R
AD  - 1 NYU Voice Center, Department of Otolaryngology-Head and Neck Surgery, New York 
      University School of Medicine, New York, New York, USA.
FAU - Amin, Milan
AU  - Amin M
AD  - 1 NYU Voice Center, Department of Otolaryngology-Head and Neck Surgery, New York 
      University School of Medicine, New York, New York, USA.
LA  - eng
PT  - Journal Article
DEP - 20170201
PL  - United States
TA  - Ann Otol Rhinol Laryngol
JT  - The Annals of otology, rhinology, and laryngology
JID - 0407300
RN  - 0 (Analgesics)
SB  - AIM
SB  - IM
MH  - Adult
MH  - Aged
MH  - *Analgesics/classification/therapeutic use
MH  - Female
MH  - Humans
MH  - *Laryngoscopy/adverse effects/methods
MH  - Male
MH  - Middle Aged
MH  - Outcome and Process Assessment (Health Care)
MH  - Pain Management/methods
MH  - Pain Measurement/methods
MH  - *Pain, Postoperative/diagnosis/drug therapy
MH  - Time Factors
OTO - NOTNLM
OT  - Friedman tongue position
OT  - analgesia
OT  - body mass index
OT  - direct laryngoscopy
OT  - narcotic
OT  - phonomicrosurgery
OT  - suspension laryngoscopy
OT  - voice
EDAT- 2017/04/12 06:00
MHDA- 2017/04/19 06:00
CRDT- 2017/04/12 06:00
AID - 10.1177/0003489417693862 [doi]
PST - ppublish
SO  - Ann Otol Rhinol Laryngol. 2017 May;126(5):375-381. doi: 10.1177/0003489417693862.
      Epub 2017 Feb 1.

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