Postoperative use of non-opioid analgesics after sinonasal surgery

Introduction Frequent opioid use after otolaryngological surgeries is common and associated with an increased morbidity and mortality. The objective of the following study was the investigation of the need, use and side effects of non-opioid analgesics after sinonasal surgery.

Methods This was a retrospective study of n = 280 patients who underwent sinonasal surgery in the Otolaryngology department of the University Erlangen-Nürnberg between January and December 2018. The postoperative pain (3-5 days after surgery) using the numeric rating scale (NRS) and the postoperative need of non-opioid analgesics in relation to demographic, radiological and surgical parameters were evaluated.

Results The mean age of the patients’ cohort was 47.2 ± 17.1 years. Men accounted for 59.3 % and women 40.7 %. At the first postoperative day the mean pain score yielded the highest values. There was a significant reduction at the second postoperative day (day 1: 1.16 ± 1.45 vs day 2: 0.89 ± 1.4, p < 0.05). 1.8 % of the patients needed an opioid analgesic. Only 2.1 % of the patients presented a postoperative bleeding complication. Women indicated a significant higher pain score value at day 1-4 (p  <  0.05 for days 1-4).

Conclusion A postoperative pain regime based on non-opioid analgesics appears to be sufficient for the pain management after sinonasal surgery. Only a small part of the study cohort needed opioid analgesics following surgery. The rate of postoperative bleeding complications was low. Our results indicate that the postoperative pain regimen should initially be started using non-opioid analgesics and be further escalated with opioid analgesics in individual cases.

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Publication History

Article published online:
10 June 2020