Postoperative pain assessment after septorhinoplasty

被引:36
作者
Wittekindt, D. [1 ]
Wittekindt, C. [1 ]
Schneider, G. [1 ]
Meissner, W. [2 ]
Guntinas-Lichius, O. [1 ]
机构
[1] Univ Jena, Univ Hosp, Dept Otorhinolaryngol, D-07740 Jena, Germany
[2] Univ Jena, Univ Hosp, Dept Anesthesiol & Intens Care Med, D-07740 Jena, Germany
关键词
Postoperative pain; Rhinoplasty; Nose; Surgery; Quality management; QUIPS; QUALITY IMPROVEMENT; MANAGEMENT; RECOMMENDATIONS; ADJUSTMENT;
D O I
10.1007/s00405-011-1854-x
中图分类号
R76 [耳鼻咽喉科学];
学科分类号
100213 ;
摘要
Postoperative pain after septorhinoplasty and its optimal management has not been described in detail. Fifty-two adult septorhinoplasty patients were included in a prospective cohort single center study. Patients' and surgical characteristics were evaluated. Outcome and process parameters were analyzed using the questionnaires of the German-wide project Quality Improvement in Postoperative Pain Management (QUIPS) on the first postoperative day. Pain during the first operative day after septorhinoplasty was moderate. Pain management predominately consisted of remifentanil intraoperatively, metamizole in the recovery room, in combination with piritramide in one-third of the patients, and metamizole on ward. Patients younger than 31 years were less satisfied with pain management ( = 0.018). Open rhinoplasty was associated with less satisfaction with pain management ( = 0.007). Use of rib grafts led to more mobility, breathing, sleeping and mood disturbances ( = 0.003, 0.047; 0.047; 0.022, respectively). Preoperative pain counseling was followed by higher satisfaction, less breathing and mood disturbances after surgery ( = 0.021; 0.004; 0.046, respectively). Opioids in the recovery room in addition to non-opioids and treatment with non-opioids on ward led to less maximal pain ( = 0.027 and 0.040, respectively). We conclude that QUIPS is an easy tool to evaluate the quality of postoperative pain management following rhinoplasty. Preoperative pain counseling, specific care for patients with rib grafts, consequent use of opioids in the recovery room in addition to non-opioids, and use of non-opioids on ward seem to be effective to improve pain management after septorhinoplasty.
引用
收藏
页码:1613 / 1621
页数:9
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