Assessment and Management of Postoperative Pain Associated with Sleep Apnea Surgery

Waxman, Jonathan; Shenouda, Kerolos; Lin, Ho‐Sheng

doi:10.1016/j.otc.2020.05.006

Cited by 5 publications

(4 citation statements)

References 81 publications

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“…Given the strong association of pain medication usage and comorbid pain syndromes with undergoing sleep surgery, surgeons should address baseline pain management and high‐medication use prior to recommending surgery. The OSA population is also at additional risk of developing opioid side effects, including sensitivity to respiratory depression and upper‐airway relaxation 18 . In a study of patients undergoing acute postoperative pain management, the prevalence of OSA conferred nearly 17‐fold greater odds of a life‐threatening respiratory event 19 .…”

Section: Discussionmentioning

confidence: 99%

“…The OSA population is also at additional risk of developing opioid side effects, including sensitivity to respiratory depression and upper-airway relaxation. 18 In a study of patients undergoing acute postoperative pain management, the prevalence of OSA conferred nearly 17-fold greater odds of a life-threatening respiratory event. 19 As many sleep surgeries require narcotic medication postoperatively, it is imperative that these patients receive appropriate counseling on postoperative expectations and that a pain plan is developed collaboratively in order to mitigate potential opioid complications.…”

Section: Discussionmentioning

confidence: 99%

“…21 Indeed, 20% of unplanned postoperative visits following UPPP are for inadequate pain control. 22 Multimodal and alternative therapies, such as gabapentin, local anesthesia, local corticosteroid, sucralfate, selective COX-2 inhibitors, 18 and aspirin, and other nonsteroidal anti-inflammatory gargles 23 have gained traction in an effort to ease the opioid burden. Optimizing preoperative pain regimens is similarly important.…”

Section: Discussionmentioning

confidence: 99%

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Association of Pain Disorder and Psychiatric Disease With Surgical Management of Obstructive Sleep Apnea

Block‐Wheeler

Darbinian

Ansari

et al. 2023

Otolaryngol.--head neck surg.

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Objective Patients undergoing surgical management for obstructive sleep apnea (OSA) are likely medically distinct from their counterparts not treated surgically. This study examined the associations between psychiatric and pain comorbidities and the likelihood of undergoing sleep surgery. Study Design A retrospective cohort study of adults with OSA. Setting Large integrated health care system. Methods The primary outcome was nonnasal, nonbariatric sleep surgery. The associations of baseline demographic and comorbid conditions with surgery to treat underlying OSA were examined using bivariable and multivariable analyses. Results Among 172,854 adults with OSA, 2456 received sleep surgery. Comorbid pain disorder and/or pain medication treatment was associated with 41% higher odds of surgery (95% confidence interval: 1.29‐1.54). In bivariable analyses, those with a history of headache (p = .004), particularly migraine (p = .003), disorders of adult personality or behavior (p = .025), or behavioral/emotional disorder (p < .001) were more likely to undergo surgery. Younger adults were also more likely to undergo surgery (mean age at diagnosis 39.8 ± 12.6 vs 54.7 ± 14 years), as were men, Asian/Pacific Islander or Hispanic adults, those with lower body mass index (32 ± 7 vs 34.3 ± 8.1 kg/m2), or those with Charlson Comorbidity Index of zero (p < .001). Conclusion Our study suggests a history of pain disorder (including receipt of pain medication), migraine, or certain behavioral and personality disorders are associated with an increased likelihood of undergoing sleep surgery. The findings may better characterize comorbid predictors of sleep surgery and potentially help clinicians tailor expectations, postoperative pain management, and overall sleep outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Association of Pain Disorder and Psychiatric Disease With Surgical Management of Obstructive Sleep Apnea

Block‐Wheeler

Darbinian

Ansari

et al. 2023

Otolaryngol.--head neck surg.

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show abstract

“…In this study, we found that maternal addition of butorphanol for analgesia was effective in reducing uterine cramping pain, suggesting that butorphanol can relieve visceral pain in postcesarean section analgesia. Postoperative pain is the main factor leading to postoperative sleep deprivation, and patients with severe sleep deprivation are prone to postoperative hyperalgesia ( 25 , 26 ). In addition, butorphanol has many advantages for PCIA after a cesarean section because of its unique pharmacological properties.…”

Section: Discussionmentioning

confidence: 99%

Analgesic and Sedative Effects of Different Doses of Dexmedetomidine Combined with Butorphanol in Continuous Analgesia after a Cesarean Section

Liu

Wang

et al. 2022

Front. Surg.

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ObjectiveThe present study is designed to study the analgesic and sedative effect of different doses of dexmedetomidine combined with butorphanol in continuous analgesia after a cesarean section.MethodsA total of 60 puerperae undergoing a cesarean section recruited from a single center were divided into three groups according to the postoperative continuous analgesia protocol: control group (100 mL of normal saline containing 10 µg/kg fentanyl and 0.25 mg of palonosetron, 2 mL/h for continuous analgesia for 48 h), DB1 group (100 mL of normal saline containing 1.0 µg/kg dexmedetomidine, 4 mg of butorphanol, 10 µg/kg fentanyl, and 0.25 mg of palonosetron, 2 mL/h for continuous analgesia for 48 h), and DB2 group (100 mL normal saline containing 2.0 µg/kg dexmedetomidine, 4 mg of butorphanol, 10 µg/kg fentanyl, and 0.25 mg of palonosetron, 2 mL/h for continuous analgesia for 48 h). We compared the blood pressure, heart rate, oxygen saturation, VAS score, Ramsay score, and adverse reactions of puerperae among the three groups after surgery.ResultsThe baseline data all have no significant difference in the three groups (p > 0.05). Compared with those in the control group, the systolic blood pressure, diastolic blood pressure, heart rate, and VAS score of the puerperae in the DB1 group and DB2 group were significantly decreased at 6, 24, and 48 h (P < 0.05), while the Ramsay scores of the puerperae in DB1 group and DB2 group were significantly increased at 6, 24, and 48 h (p < 0.05). At the same time, the systolic blood pressure, diastolic blood pressure, heart rate, and VAS score of the puerperae in the DB2 group were significantly lower than those in the DB1 group (P < 0.05), while the Ramsay scores of the puerperae in DB2 group were significantly higher than those in the DB1 group (P < 0.05). Also, there is no significant difference in oxygen saturation and adverse reactions of puerperae among the three groups after surgery (p > 0.05).ConclusionDexmedetomidine combined with butorphanol can improve the analgesic and sedative effects in continuous analgesia after a cesarean section, and the analgesic and sedative effects of dexmedetomidine in the high-dose group are better than those in the low-dose group.

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Does pregabalin act in pain control after lateral pharyngoplasties and tonsillectomies? A pilot study

Rocha¹,

Mello²,

Silva³

et al. 2022

Sleep Breath

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Assessment and Management of Postoperative Pain Associated with Sleep Apnea Surgery

Cited by 5 publications

References 81 publications

Association of Pain Disorder and Psychiatric Disease With Surgical Management of Obstructive Sleep Apnea

Association of Pain Disorder and Psychiatric Disease With Surgical Management of Obstructive Sleep Apnea

Analgesic and Sedative Effects of Different Doses of Dexmedetomidine Combined with Butorphanol in Continuous Analgesia after a Cesarean Section

Does pregabalin act in pain control after lateral pharyngoplasties and tonsillectomies? A pilot study

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