title: Treatment of pain after head and neck surgeries: control of acute pain after head and neck oncological surgeries.
abstract: OBJECTIVE
  To devise an effective postoperative analgesic protocol.
  
  
  METHODS
  Two consecutive groups participated in this study. In the first group (n = 100), the pain-control management was pro re nata (PRN). In the second group, (n = 109) we tailored a procedure-specific pain-control protocol for each patient according to the level of pain recorded in the first group. These patients were treated with analgesics given at predetermined hours. Pain was evaluated by using a verbal scale of 1 to 10.
  
  
  RESULTS
  In the first group, a significant reduction in the level of pain was monitored 1 hour after PRN drug administration; however, patients reported the return of pain several hours later, after the drug effect subsided. Overall, the patients suffered a substantial level of pain during the entire postoperative period. In the second group, significant reduction in the level of pain was recorded throughout the hospitalization.
  
  
  CONCLUSIONS
  The PRN protocol is not adequate for management of pain after head and neck surgeries.
  
  
  CONCLUSIONS
  We can substantially reduce our patients' postoperative pain by adopting a procedure-specific analgesic regimen instead of a PRN regimen.
  
  
  METHODS
  B-3b.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. ziv@baseofskull.org
authors.forename: Ziv
authors.initials: Z
authors.lastname: Gil
authors.forename: Darryl B
authors.initials: DB
authors.lastname: Smith
authors.forename: Nissim
authors.initials: N
authors.lastname: Marouani
authors.forename: Avi
authors.initials: A
authors.lastname: Khafif
authors.forename: Dan M
authors.initials: DM
authors.lastname: Fliss
mesh_terms: D000328:Adult; D000368:Aged; D000698:Analgesia; D016058:Analgesia, Patient-Controlled; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D002985:Clinical Protocols; D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000627:therapeutic use; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D011446:Prospective Studies; D014147:Tramadol / Q000627:therapeutic use
chemical_list: D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal; D014147:Tramadol; D009020:Morphine