Preoperative Acetaminophen For Microsuspension Laryngoscopy Reduces Postoperative Opioid Use
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Date
2024
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Abstract
Objectives: The opioid crisis has prompted consideration of analgesic prescriptions. This study explored the value of pre-operative acetaminophen for pain control following microsuspension laryngoscopy (MSL) and compared the results with a pre-vious study of pain and opioid use following MSL (Tsang et al.). Methods: A prospective open-label clinical trial was conducted in patients undergoing MSL. All patients were adminis-tered preoperative acetaminophen. Short-form McGill Pain Questionnaire (SF-MPQ), pain visual analogue scale (VAS), and pre-sent pain intensity (PPI) scores were collected preoperatively and on postoperative days (PODs) 1, 3, 7, and 14. Statisticalanalysis identified variables associated with opioid use or increased pain scores, and compared outcomes with Tsang et al. Results: Eighty-nine patients were included (mean age 52.8 17.3 years, 40 males). All patients received preoperative1 g acetaminophen (77 (86.5%) orally) with no adverse effects. On POD1, opioid usage was 10%. Median [IQR] pain scoreswere 5 [2–11], 21 [12.3–56.8], and 3 [2–3.3] on SF-MPQ, VAS, and PPI, respectively. Post-Anesthesia Care Unit (PACU) opioidr equirements significantly correlated with POD1 opioid consumption (τb = 0.214; p ≤ 0.05), and significant associations with PACU opioid administration were found for total anesthesia time (OR (95%CI) = 1.271 (1.043–1.548), p = 0.017) and totallaryngoscope suspension time (OR (95%CI) = 0.791 (0.651–0.962, p = 0.019)). This cohort demonstrated reduced opioidusage on POD1 compared with Tsang et al (23%). Conclusions: Preoperative acetaminophen is a safe intervention, resulting in decreased postoperative opioid use follow-ing MSL. Anesthesia time correlated with need for postoperative opioids
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Keywords
Microlaryngoscopy, Microsuspension laryngoscopy, Narcotic analgesics, Opioids, Postoperative pain