Nonopioid perioperative analgesia in head and neck cancer surgery:A systematic review

作     者：Beatrice C.Go Cammille C.Go Kevin Chorath Alvaro Moreira Karthik Rajasekaran Beatrice C. Go;Cammille C. Go;Kevin Chorath;Alvaro Moreira;Karthik Rajasekaran

作者机构：Department of OtorhinolaryngologyUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA Department of PediatricsDivision of NeonatologyUniversity of Texas Health-San AntonioSan AntonioTexasUSA Leonard Davis Institute of Health EconomicsUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA 

出 版 物：《World Journal of Otorhinolaryngology-Head and Neck Surgery》 (世界耳鼻咽喉头颈外科杂志（英文）)

年 卷 期：2022年第8卷第2期

页      面：107-117页

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：analgesia head and neck neoplasm NSAID opioids pain management 

摘      要：Objective:Management of postoperative pain after head and neck cancer surgery is a complex issue,requiring a careful balance of analgesic properties and side *** objective of this review is to discuss the efficacy and safety of multimodal analgesia(MMA)for these ***:Pubmed,Cochrane,Embase,Scopus,and *** were systematically searched for all comparative studies of patients receiving MMA(nonsteroidal anti-inflammatory drugs(NSAIDs),acetaminophen,anticonvulsants,local anesthetics,and corticosteroids)for head and neck cancer *** primary outcome was additional postoperative opioid usage,and secondary outcomes included subjective pain scores,complications,adverse effects,and 30-day ***:A total of five studies representing 592 patients(MMA,n=275;non-MMA,n=317)met inclusion *** most commonly used agents were gabapentin,NSAIDs,and acetaminophen(n=221),NSAIDs(n=221),followed by corticosteroids(n=35),dextromethorphan(n=40),and local nerve block(n=19).Four studies described a significant decrease in overall postoperative narcotic usage with two studies reporting a significant decrease in hospital *** pain scores widely varied with two studies reporting reduced pain at postoperative day *** were no differences in surgical outcomes,medical complications,adverse effects,or 30-day mortality and readmission ***:MMA is an increasingly popular strategy that may reduce dependence on opioids for the treatment of postoperative pain.A variety of regimens and protocols are available for providers to utilize in the appropriate head and neck cancer patient.