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
Rok vydání: 2020
Předmět:
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