Locoregional strategies to decrease postoperative pain and neck discomfort after open thyroidectomy: A scoping review.
Álvaro SanabriaCarlos BetancourtCarlos-Miguel Chiesa-EstombaAndrés Coca-PelazEwa FlorekOrlando Guntinas-LichiusFernando LópezAntti A MäkitieIain James NixonGregory RandolphAlessandra RinaldoJuan Pablo RodrigoAshok R ShahaRalph P TufanoMark ZafereoAlfio FerlitoPublished in: Head & neck (2023)
Adequate pain control enhances patients' quality of life and allows a quick return to normal activities. Current pain management practices may contribute to the crisis of opioid addiction. We summarize the evidence that evaluates locoregional interventions to decrease pain and neck discomfort after thyroidectomy. We designed a scoping review. The search strategy was made in the Pubmed/MEDLINE and EMBASE database. We included only systematic reviews and RCTs that compared two or more strategies. Forty-nine publications including 5045 patients fulfilled criteria. Sore throat frequency is higher for endotracheal intubation and topical administration of anesthetic before intubation decreases this. Pre-incisional infiltration of the surgical wound decreases postoperative pain. Bilateral superficial plexus nerve block decreases analgesic requirements during and after thyroidectomy. Wound massage and neck exercises decrease postoperative discomfort. Locoregional interventions significantly impact postoperative pain and may reduce opioid use and improve patient outcomes.
Keyphrases
- postoperative pain
- pain management
- chronic pain
- end stage renal disease
- newly diagnosed
- ejection fraction
- systematic review
- healthcare
- primary care
- cardiac arrest
- prognostic factors
- neuropathic pain
- physical activity
- public health
- squamous cell carcinoma
- patient reported outcomes
- emergency department
- spinal cord
- lymph node metastasis
- minimally invasive
- ultrasound guided
- adverse drug
- case report