Pain Control in Head and Neck Cancer

Kuo, Ping-Yi; Williams, John E.

doi:10.5772/33640

Cited by 5 publications

(4 citation statements)

References 53 publications

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“…Based on our clinical experience in managing post-XRT patients with HNC, we observed that chronic pain is commonly encountered; however, there are very limited data in the literature on the characteristics of chronic pain among HNC patients treated with XRT. Kuo and Williams listed 14 studies investigating pain in HNC patients, in which 3 studies reported persistence of pain up to 6–24 months, and prevalence of pain varied from 15% to 46% [16]. Only one study focused on post-XRT pain in HNC patients [11].…”

Section: Discussionmentioning

confidence: 99%

Characteristics of Chronic Pain among Head and Neck Cancer Patients Treated with Radiation Therapy: A Retrospective Study

Kallurkar

Kulkarni

Delfino

et al. 2019

Pain Research and Management

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Pain is common among patients with head and neck cancer (HNC). However, there are very limited data on chronic pain among HNC patients treated with radiation therapy (XRT). In this retrospective study, we focused on the characteristics of chronic post-XRT pain in such patients. Post-XRT pain is common among HNC patients; however, we found discrepancy between frequency of treatment and frequency of chronic pain, suggesting poor documentation of pain in the medical records. Among patients who reported to have chronic post-XRT pain, most of them described having severe pain and used descriptors of neuropathic pain. Pharynx was the commonest site of cancer as well as the commonest site of cancer-related chronic pain; squamous cell carcinoma was the most frequent histological pattern, and opioids were used most often to treat such chronic pain. There was a significant association between chronic pain and number of sites of pain, and chronic pain was also associated with use of opioids.

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Section: Discussionmentioning

confidence: 99%

Characteristics of Chronic Pain among Head and Neck Cancer Patients Treated with Radiation Therapy: A Retrospective Study

Kallurkar

Kulkarni

Delfino

et al. 2019

Pain Research and Management

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“…Most of the data from the literature indicate that management of acute postoperative pain is still sub-optimal, and that only 35% of post-laryngectomy patients received adequate and effective pain management [28,29]. Inadequate postoperative pain management was correlated with a prolonged hospital stay, immunosuppression, patient immobility, and increased morbidity [30].…”

Section: Discussionmentioning

confidence: 99%

Oxidative Stress and Inflammation Biomarkers in Postoperative Pain Modulation in Surgically Treated Patients with Laryngeal Cancer—Pilot Study

Vujović

Živković

Dožić

et al. 2023

Cells

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(1) Background: Surgical treatment of laryngeal carcinoma includes different types of laryngectomies with neck dissection. Surgical tissue damage triggers an inflammatory response, leading to the release of pro-inflammatory molecules. This increases reactive oxygen species production and decreases antioxidant defense mechanisms, leading to postoperative oxidative stress. The aim of this study was to assess the correlation between oxidative stress (malondialdehyde, MDA; glutathione peroxidase, GPX; superoxide dismutase, SOD) and inflammation (interleukin 1, IL-1; interleukin-6, IL-6; C–reactive protein, CRP) parameters and postoperative pain management in patients surgically treated with laryngeal cancer. (2) Methods: This prospective study included 28 patients with surgically treated laryngeal cancer. Blood samples were taken for the analysis of oxidative stress and inflammation parameters before the operative treatment and after the operative treatment (1st postoperative day and 7th postoperative day). The concentrations of MDA, SOD, GPX, IL-1, IL-6, and CRP in the serum were determined by coated enzyme-linked immunosorbent assay (ELISA). The visual analog scale (VAS) was used for pain assessment. (3) Results and conclusion: There was a correlation between oxidative stress and inflammation biomarkers and postoperative pain modulation in surgically treated patients with laryngeal cancer. Age, more extensive surgery, CRP values, and use of tramadol were predictors for oxidative stress parameters.

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“…Few studies of perioperative pain management in major head and neck cancer surgery with free flap reconstruction have been published. Studies that have been published show a high reliance on narcotic based pain control [ 8 , 9 ]. We believe that multimodal analgesic protocols, as shown in other surgical disciplines, will reduce the need for postoperative narcotics in head and neck cancer patients and the complications that attend their use [ 16 – 18 ].…”

Section: Discussionmentioning

confidence: 99%

“…Effective postoperative pain control can shorten hospital stay, improve short-term post-operative outcomes, and decrease morbidity [ 7 ]. Additionally, poorly managed acute postoperative pain is often associated with chronic pain [ 8 ]. Major head and neck cancer resections with free flap reconstruction are lengthy and complex procedures and patients often require nasogastric and tracheotomy tubes.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of postoperative pain management in head and neck cancer patients

Hinther¹,

Nakoneshny²,

Chandarana³

et al. 2018

Journal of Otolaryngology - Head & Neck Surgery

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BackgroundOur study quantifies the effectiveness of perioperative pain control in a cohort of patients undergoing major head and neck surgery with free flap reconstruction. Our long-term goal is to improve pain control and thereby increase mobility, decrease postoperative complications and decrease hospital stay.MethodsA retrospective analysis was performed at a tertiary, academic head and neck surgical oncology program in Calgary, Alberta, Canada from January 1, 2015 – December 31, 2015. Pain scores were recorded prospectively. Primary outcomes were frequency of postoperative pain assessments and pain intensity using the numeric rating scale.ResultsThe cohort included 41 patients. Analysis was limited to pain scores recorded from postoperative days 1–14. There was an average of 7.3 pain measurements per day (SD 4.6, range 1–24) with the most frequent monitoring on postoperative days 1–4.Median pain scores ranged from 0 to 4.5 with the highest median score on postoperative day 6. The daily maximum pain scores recorded ranged from 8 to 10 with scores of 10 recorded on postoperative days 1, 2, 3, 5, 7, 8, and 10.Patients most frequently had inadequate pain control on postoperative days 1, 2, 4, and 5 with the majority occurring on postoperative day 1.ConclusionsPostoperative pain control could be improved at our centre. The frequency of pain assessments is also highly variable. Ongoing measurement, audit, and feedback of analgesic protocol effectiveness is an excellent first step in improving perioperative pain management in patients undergoing major head and neck cancer surgery with free flap reconstruction.

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Pain Control in Head and Neck Cancer

Cited by 5 publications

References 53 publications

Characteristics of Chronic Pain among Head and Neck Cancer Patients Treated with Radiation Therapy: A Retrospective Study

Characteristics of Chronic Pain among Head and Neck Cancer Patients Treated with Radiation Therapy: A Retrospective Study

Oxidative Stress and Inflammation Biomarkers in Postoperative Pain Modulation in Surgically Treated Patients with Laryngeal Cancer—Pilot Study

Efficacy of postoperative pain management in head and neck cancer patients

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