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Pain Varies After Ear, Nose and Throat Surgeries

Factors predicting unacceptable pain include surgical site, degree of pain catastrophizing

TUESDAY, Feb. 17 (HealthDay News) -- Certain factors may be helpful in predicting postoperative pain in patients undergoing ear, nose and throat surgery, according to research published in the February issue of the Archives of Otolaryngology -- Head & Neck Surgery.

Michael Sommer, M.D., of the University Hospital Maastricht in the Netherlands, and colleagues analyzed data from 217 adults undergoing ear, nose and throat surgery. The researchers collected data before surgery on patients' tendency to catastrophize, surgical fear and expected pain. Patients recorded their pain levels on the day of surgery and four postoperative days using a visual analog scale (VAS), with a mean score of 40 mm or higher considered unacceptable.

Half of the patients undergoing surgery on oral, pharyngeal, laryngeal, neck, and salivary gland regions had a VAS score higher than 40 mm on day one, the investigators found. Fewer than 30 percent of patients undergoing endoscopic procedures and fewer than 20 percent of ear or nose surgery patients had a VAS score higher than 40 mm. Factors predicting pain in multivariate analysis were site of operation, preoperative pain and pain catastrophizing, the researchers report.

"The data of the present study demonstrate that there are large differences in levels of postoperative pain after ear, nose and throat surgery if the anatomical site is considered. Although some large studies measured the amount of pain in different surgical categories, like abdominal or orthopedic surgery, this study shows that this categorization is probably not sufficient because major differences in pain sensation manifest themselves within ear, nose and throat surgery," the authors write.

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