Head & neck · 2026
A Multimodal Analgesia Protocol to Reduce Opioid Use Following Oral Cavity Free Flap Reconstruction.
СтатьяНазвание и аннотация: Перевод в очереди
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Levy Ben B, Wiercigroch Julia, Choudhary Lomesh, Shemesh-Lobl Tamar, de Almeida John R, Goldstein David P, Gilbert Ralph W, Irish Jonathan C, Brown Dale H, Yao Christopher M K L, Tzelnick Sharon
Аннотация
BACKGROUND: Opioid-based patient-controlled analgesia (PCA) is widely used after head and neck cancer surgery but carries risks such as dependence, sedation, and respiratory depression. Multimodal analgesia (MMA) may offer acceptable pain control with fewer adverse effects.
METHODS: We retrospectively analyzed patients who underwent oral cavity resection with free flap reconstruction over 18 months. An MMA regimen of scheduled acetaminophen, celecoxib, and gabapentin was compared to PCA. Outcomes included opioid use, pain scores, and complications.
RESULTS: A total of 237 patients were included (PCA: n = 120; MMA: n = 117). The mean age was 64.3 years (SD = 13.2). Opioid use was significantly lower in the MMA group on all postoperative days (PODs), with the greatest mean differences on POD 1 (MD = 75.3) and POD 2 (MD = 31.9) (both p < 0.001). Pain scores were significantly lower in the MMA group on all PODs (p < 0.05).
CONCLUSIONS: MMA can provide comparable pain control while significantly reducing opioid use following oncologic oral cavity resection with free flap reconstruction.
METHODS: We retrospectively analyzed patients who underwent oral cavity resection with free flap reconstruction over 18 months. An MMA regimen of scheduled acetaminophen, celecoxib, and gabapentin was compared to PCA. Outcomes included opioid use, pain scores, and complications.
RESULTS: A total of 237 patients were included (PCA: n = 120; MMA: n = 117). The mean age was 64.3 years (SD = 13.2). Opioid use was significantly lower in the MMA group on all postoperative days (PODs), with the greatest mean differences on POD 1 (MD = 75.3) and POD 2 (MD = 31.9) (both p < 0.001). Pain scores were significantly lower in the MMA group on all PODs (p < 0.05).
CONCLUSIONS: MMA can provide comparable pain control while significantly reducing opioid use following oncologic oral cavity resection with free flap reconstruction.
Предметные рубрики MeSH
HumansMiddle AgedFemaleMaleRetrospective StudiesAnalgesics, OpioidFree Tissue FlapsPostoperative PainAgedAcetaminophenMouth NeoplasmsAnalgesia, Patient-ControlledPlastic Surgery ProceduresPain MeasurementGabapentinCelecoxibPain ManagementCyclohexanecarboxylic AcidsAminesAnalgesicsTreatment OutcomeAnalgesics, Non-Narcotic