Multimodal analgesia in outpatient head and neck surgery: A feasibility and safety study

Narcotics are most commonly prescribed analgesia during the head and neck surgery. But these are more prone to adverse effects and opioid abuse or dependence. Therefore, in this research, Justin Oltman et al investigated the new multimodal analgesia model and revealed its safety in patients undergoing outpatient head and neck surgery and may reduce the need for narcotic use.

Perioperative analgesia approaches that depend individually on narcotics may contribute to unfavourable outcomes and concerns regarding opioid misuse or dependence. Multimodal analgesia protocols including nonnarcotic agents may lessen the demand for postoperative narcotic use. To assess the usefulness and safety of a multimodal analgesia protocol for outpatient head and neck surgical methods and to recognise the relationship of multimodal analgesia protocol with postoperative pain perception scores and patient satisfaction.

Data comprising adults who went through outpatient parathyroid, thyroid, parotid surgery from July 2016 and February 2017 using a multimodal analgesia strategy with the application of immediate preoperative Gabapentin and Acetaminophen were collected and elucidate plan to manage with a nonnarcotic postoperative outpatient analgesia strategy. Overall Benefit of Analgesia Score (OBAS), median resting & peak pain scores, and total patient satisfaction scores were assessed as the study's outcomes. Also, conflicting effects linked to altered analgesia procedure and rate of dependence on a narcotic-based postoperative outpatient analgesia procedure were recorded.

A total of sixty-four participants went through outpatient parathyroid, thyroid, or parotid surgery with the introduction of a multimodal analgesia protocol. Participants described low resting pain perception scores and peak pain scores using a 10-point rating scale. The OBAS evaluation for composite efficacy of analgesia showed a favourable median score of 1. Thirty-nine participants were ready to withdraw postoperative narcotic use on discharge. Fifty-six participants described “high” or “very high” satisfaction with the multimodal analgesia strategy. No complications linked to hematoma, bleeding, notable adverse events or readmissions were seen.

A multimodal analgesia strategy was safe and feasible among individuals going through outpatient head and neck surgery and may decrease the demand for narcotic use. It was correlated with favourable OBAS, low pain perception scores, and overall satisfaction scores. The multimodal analgesia requires further investigation through comparative efficacy evaluation vs conventional pain management approaches.