[Postoperative pain evaluation in the surgery of head and neck cancers].
Postoperative pain has rarely been assessed after ENT surgery for cancer. Its evaluation is difficult because of the frequent lack of speech after this type of surgery.


OBJECTIVE
to assess postoperative pain after pharyngeal and laryngeal surgery for cancer.


METHODS
prospective study in 13 men (38-71 ans) operated on by total laryngectomy with or without partial pharyngectomy. A standardised treatment using propacetamol and nalbuphine was systematically prescribed. Pain, anxiety and relief were assessed with the help of visual analogue scales (VAS). Heart rate, mean blood pressure and respiratory rate were evaluated too.


RESULTS
mean postoperative pain was maximal just after recovery (6,64 +/- 2,14 cm) then decreased regularly. Initial mean score of anxiety was 3,14 +/- 3 cm and then was decreasing too. Anxiety and pain did not correlate except in 2 cases. None of the 3 objective parameters correlated with pain.


CONCLUSIONS
postoperative pain can be assessed reliably after pharyngolaryngeal cancer surgery and is probably underrated. Its high initial score indicates that efforts must be focused on pre-emotive analgesia. Its high individual variability let us hypothesise that PCA systems should be effective.
Mom
T
T
CHU Clermont-Ferrand, Service d'O.R.L. et de chirurgie cervicofaciale, France.
Commun
F
F
Derbal
C
C
Dubray
C
C
Eschalier
A
A
Bost
P
P
Avan
P
P
Bazin
J E
JE
Gilain
L
L
D000328:Adult; D000368:Aged; D016058:Analgesia, Patient-Controlled; D001008:Anxiety Disorders / Q000188:drug therapy / Q000209:etiology; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D007825:Laryngectomy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain; D011446:Prospective Studies; D014139:Tracheostomy; D014140:Tracheotomy
Evaluation de la douleur post-opératoire en chirurgie carcinologique cervico-faciale.