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Michael Sommer, MD; José W. J. M. Geurts, MSc; Bjorn Stessel, MD; Alfons G. H. Kessels, MD, MSc; Madelon L. Peters, PhD; Jacob Patijn, MD, PhD; Maarten van Kleef, MD, PhD; Bernd Kremer, MD, PhD; Marco A. E. Marcus, MD, PhD

Arch Otolaryngol Head Neck Surg. 2009;135(2):124-130.

Objective  To determine postoperative pain in different types of ear, nose, and throat (ENT) surgery and their psychological preoperative predictors.

Design  Prospective cohort study.

Setting  Academic hospital.

Patients  A total of 217 patients undergoing ENT surgery.

Interventions  All ENT, neck, and salivary gland surgery.

Main Outcome Measures  Postoperative pain and predictors for postoperative pain.

Results  Fifty percent of the patients undergoing surgery on the oral, pharyngeal, and laryngeal region and on the neck and salivary gland region had a visual analog scale score higher than 40 mm on day 1. In the patients who underwent oropharyngeal region operations the VAS score remained high on all 4 days. A VAS pain score higher than 40 mm was found in less than 30% of patients after endoscopic procedures and less than 20% after ear and nose surgery. After bivariate analysis, 6 variables–age, sex, preoperative pain, expected pain, short-term fear, and pain catastrophizing–had a predictive value. Multivariate analysis showed only preoperative pain, pain catastrophizing, and anatomical site of operation as independent predictors.

Conclusions  Differences exist in the prevalence of unacceptable postoperative pain between ENT operations performed on different anatomical sites. A limited set of variables can be used to predict the occurrence of unacceptable postoperative pain after ENT surgery.

Author Affiliations: Departments of Anesthesiology and Pain Treatment (Drs Sommer, Stessel, Patijn, van Kleef, and Marcus and Mr Geurts), Clinical Epidemiology and Statistics (Dr Kessels), and Otorhinolaryngology and Head and Neck Surgery (Dr Kremer), University Hospital Maastricht, and Department of Clinical Psychological Science, University Maastricht (Dr Peters), Maastricht, the Netherlands.

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