title: Postoperative pain scores and analgesic requirements after thyroid surgery: comparison of three intraoperative opioid regimens.
abstract: OBJECTIVE
  This study was designed to compare the effect on postoperative pain, opioid consumption and the length of stay in postoperative care unit (PACU) after three different intraoperative analgesic regimens in thyroid surgery.
  
  
  METHODS
  Seventy five patients were enrolled into the study and assigned to one of three groups, fentanyl, sufentanil or remifentanil (n=25 for each group). Before the end of surgery, paracetamol 1 gr and nefopam 20 mg was also administered in all patients. Pain scores, opioid demand and the length of stay in PACU were assessed in a blind manner.
  
  
  RESULTS
  Post operative pain scores were significantly lower in the fentanyl and sufentanil groups compared to remifentanil group (55 +/- 15, and 60 +/- 10 versus 78+/- 12, P < 0.05). Patients in the remifentanil group stayed longer in the PACU 108+/- 37 min versus 78+/-31 and 73 +/- 25 min, (P< 0.05).
  
  
  CONCLUSIONS
  After remifentanil based analgesia, anticipation of postoperative pain with opioid analgesic appears mandatory even for surgery rated as being moderately painful, otherwise longer opioid titration due to higher pain scores might delay discharge time.
authors.affiliation: Service d'Anesthesie Réanimation Hospital Henri Mondor, Créteil APHP, Université Paris 12, France. motamed@igr.fr
authors.forename: C
authors.initials: C
authors.lastname: Motamed
authors.forename: J C
authors.initials: JC
authors.lastname: Merle
authors.forename: L
authors.initials: L
authors.lastname: Yakhou
authors.forename: X
authors.initials: X
authors.lastname: Combes
authors.forename: J
authors.initials: J
authors.lastname: Vodinh
authors.forename: C
authors.initials: C
authors.lastname: Kouyoumoudjian
authors.forename: P
authors.initials: P
authors.lastname: Duvaldestin