Author:
Bang Yu Jeong,Kim Sojin,Kim Jin Kyoung,Kim Hara,Kim Seungmo,Chung Chi Song,Yoo Seung Yeon,Jeong Heejoon,Park Boram,Lee Sang Hyun
Abstract
Abstract
Background
A simulated education, prior to surgery about postoperative nasal stuffiness and ease of breathing through the mouth may help patients tolerate discomfort after nasal surgery. This study aimed to investigate the effect of preoperative simulated education on immediate postoperative opioid requirements in patients undergoing elective nasal surgery.
Methods
This randomized controlled trial of 110 patients undergoing nasal surgery randomly allocated patients into either a control (group C) or an education group (group E). One day before surgery, patients in group E were intensively trained to breathe through the mouth by using a nasal clip, with informative explanations about inevitable nasal obstruction and discomfort following surgery. Patients in group C were provided with routine preoperative information. Total intravenous anesthesia (TIVA) with propofol and remifentanil was used for anesthesia. No further opioid was used for analgesia intraoperatively. The primary outcome was index opioid (fentanyl) requirements at the post-anesthesia recovery unit (PACU). Secondary outcomes were emergence agitation, pain scores at the PACU, and postoperative recovery using the Quality of Recovery-15 (QoR15-K).
Results
The rate of opioid use in the PACU was 51.0% in the group E and 39.6% in the group C (p = 0.242). Additional request for analgesics other than index opioid was not different between the groups. Emergence agitation, postoperative pain severity, and QoR15-K scores were comparable between the groups.
Conclusion
Preoperative education with simulated mouth breathing in patients undergoing nasal surgery did not reduce opioid requirements.
Trial registration
KCT0006264; 16/09/2021; Clinical Research Information Services (https://cris.nih.go.kr).
Publisher
Springer Science and Business Media LLC
Subject
Anesthesiology and Pain Medicine
Reference28 articles.
1. Service KNHI. Main Surgery Statstical Yearbook of 2020.
2. Davis GE, Yueh B, Walker E, Katon W, Koepsell TD, Weymuller EA. Psychiatric distress amplifies symptoms after Surgery for chronic rhinosinusitis. Otolaryngology–head and neck Surgery: Official Journal of American Academy of Otolaryngology-Head and Neck Surgery. 2005;132(2):189–96.
3. Maniaci A, Merlino F, Cocuzza S, Iannella G, Vicini C, Cammaroto G, Lechien JR, Calvo-Henriquez C, La Mantia I. Endoscopic surgical treatment for rhinogenic contact point headache: systematic review and meta-analysis. Eur Arch Otorhinolaryngol. 2021;278(6):1743–53.
4. Gropper MA, Miller RD, Eriksson LI, Fleisher LA, Wiener-Kronish JP, Cohen NH, Leslie K. Miller’s anesthesia, 2-volume set E-book. Elsevier Health Sciences; 2019.
5. Lee JT, Levine CG, Overdevest JB, Higgins TS, Manes RP, Myhill JA, Soler ZM. American Rhinologic Society expert practice statement: postoperative pain management and opioid use after sinonasal Surgery. Int Forum Allergy Rhinol. 2021;11(9):1296–307.