Association of multimodal analgesia with perioperative safety and opioid use following head and neck microvascular reconstruction
Autor: | Oleg Militsakh, Andrew Coughlin, John J. Hufnagle, William Lydiatt, Sarah Aurit, Daniel D. Lydiatt, Robert Lindau, Angela Osmolak, Aru Panwar, Navdeep R. Sayal, Lester D Hubble |
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Rok vydání: | 2020 |
Předmět: |
Pain
Postoperative business.industry Opioid use Free flap Perioperative Plastic Surgery Procedures 030230 surgery Confidence interval Analgesics Opioid 03 medical and health sciences 0302 clinical medicine Otorhinolaryngology Opioid 030220 oncology & carcinogenesis Anesthesia Morphine Humans Medicine In patient Analgesia Head and neck business Pain Measurement Retrospective Studies medicine.drug |
Zdroj: | Head & Neck. 42:2887-2895 |
ISSN: | 1097-0347 1043-3074 |
DOI: | 10.1002/hed.26341 |
Popis: | BACKGROUND This study examines the association of multimodal analgesia (MMA) protocol for head and neck microvascular reconstruction with postoperative safety and opioid use. METHODS Retrospective, intention-to-treat analysis of 226 patients undergoing head and neck microvascular reconstruction between January 1, 2014 and August 30, 2018 at a tertiary-care hospital following MMA protocol implementation. Multivariable models examined outcomes of interest. RESULTS There were no differences between groups in frequency of bleeding, return to operating room, complete flap loss, readmissions, wound complications, and 30-day mortality. Patients in MMA protocol experienced reduced likelihood of partial flap loss (OR 0.18, confidence interval 0.04-0.91), meaningful reduction in postoperative opioid use (cumulative inpatient morphine equivalents [64 vs 141 mg; P |
Databáze: | OpenAIRE |
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