Locoregional strategies to decrease postoperative pain and neck discomfort after open thyroidectomy: A scoping review

Author:

Sanabria Alvaro12ORCID,Betancourt Carlos2,Chiesa‐Estomba Carlos3ORCID,Coca‐Pelaz Andrés4ORCID,Florek Ewa5,Guntinas‐Lichius Orlando6ORCID,Lopez Fernando4ORCID,Mäkitie Antti A.78,Nixon Iain J.9ORCID,Randolph Gregory10,Rinaldo Alessandra11ORCID,Rodrigo Juan Pablo4ORCID,Shaha Ashok R.12ORCID,Tufano Ralph P.13,Zafereo Mark14,Ferlito Alfio15ORCID

Affiliation:

1. Department of Surgery Universidad de Antioquia Medellín Colombia

2. CEXCA Centro de Excelencia en Enfermedades de Cabeza y cuello Medellín Colombia

3. Department of Otorhinolaryngology – Head & Neck Surgery Hospital Universitario Donostia‐Biodonostia Research Institute San Sebastian Spain

4. Department of Head and Neck Surgery, Hospital Universitario Central de Asturias (HUCA)‐Instituto Universitario de Oncología del Principado de Asturias, Instituto de Investigación Sanitaria del Principado de Asturias University of Oviedo, CIBERONC Oviedo Spain

5. Laboratory of Environmental Research, Department of Toxicology Poznan University of Medical Sciences Poznan Poland

6. Department of Otorhinolaryngology Jena University Hospital Jena Germany

7. Department of Otorhinolaryngology – Head and Neck Surgery, Helsinki University Hospital University of Helsinki Helsinki Finland

8. Research Program in Systems Oncology, Faculty of Medicine University of Helsinki Helsinki Finland

9. Department of Otorhinolaryngology – Head and Neck Surgery NHS Lothian Edinburgh UK

10. Division of Otolaryngology – Endocrine Head and Neck Surgery, Massachusetts Eye and Ear Infirmary Harvard University Boston Massachusetts USA

11. ENT Unit Policlinico Città di Udine Udine Italy

12. Head and Neck Service Memorial Sloan‐Kettering Cancer Center New York New York USA

13. FPG Thyroid and Parathyroid Center, Division of Head and Neck Endocrine Surgery The Sarasota Memorial Health Care System Sarasota Florida USA

14. Department of Head and Neck Surgery The University of Texas M. D. Anderson Cancer Center Houston Texas USA

15. Coordinator of the International Head and Neck Scientific Group Padua Italy

Abstract

AbstractAdequate 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.

Publisher

Wiley

Subject

Otorhinolaryngology

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