The Journal of craniofacial surgery · 2026
Postoperative Pain Management in Orthognathic Surgery: Is There a Need for Opioids?
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Stoll P D, Thol F, Spuck N, Kramer F-J, Heim N, Warwas F B
Аннотация
INTRODUCTION: Orthognathic surgery is traditionally considered painful, often prompting opioid use. In the context of rising opioid-related harm, this study assessed postoperative pain levels, factors influencing analgesic requirements, and the actual need for opioids after orthognathic procedures.
METHODS: A retrospective analysis of 122 patients undergoing Le-Fort-I osteotomy, bilateral sagittal split osteotomy (BSSO), or bimaxillary surgery was performed. Pain levels (Numeric Analog Scale) were recorded 3 times daily for 5 postoperative days. Analgesic use was documented according to the WHO analgesic ladder, and associations with surgical type, gender, maxillary impaction, and mandibular advancement were analyzed.
RESULTS: Pain levels were mild overall and declined steadily over 5 days. BSSO patients reported the lowest pain and required fewer non-opioid analgesics. Le-Fort-I and bimaxillary procedures showed higher early analgesic demand. Only 5.7% of patients required opioid rescue medication, with no corresponding increase in pain scores. Gender, maxillary impaction, and mandibular advancement showed no significant impact on analgesic requirements.
DISCUSSION: Non-opioid analgesics effectively controlled postoperative pain across procedures, and no subgroup demonstrated a consistent need for opioids.
CONCLUSIONS: Routine opioid prescription after orthognathic surgery seems unnecessary. Opioid-sparing protocols provide adequate pain control and support safer postoperative recovery.
METHODS: A retrospective analysis of 122 patients undergoing Le-Fort-I osteotomy, bilateral sagittal split osteotomy (BSSO), or bimaxillary surgery was performed. Pain levels (Numeric Analog Scale) were recorded 3 times daily for 5 postoperative days. Analgesic use was documented according to the WHO analgesic ladder, and associations with surgical type, gender, maxillary impaction, and mandibular advancement were analyzed.
RESULTS: Pain levels were mild overall and declined steadily over 5 days. BSSO patients reported the lowest pain and required fewer non-opioid analgesics. Le-Fort-I and bimaxillary procedures showed higher early analgesic demand. Only 5.7% of patients required opioid rescue medication, with no corresponding increase in pain scores. Gender, maxillary impaction, and mandibular advancement showed no significant impact on analgesic requirements.
DISCUSSION: Non-opioid analgesics effectively controlled postoperative pain across procedures, and no subgroup demonstrated a consistent need for opioids.
CONCLUSIONS: Routine opioid prescription after orthognathic surgery seems unnecessary. Opioid-sparing protocols provide adequate pain control and support safer postoperative recovery.