Alleviation of wound pain after surgeries for obstructive sleep apnea.
OBJECTIVE
There has been growing awareness that alleviation of wound pain and associated symptoms after obstructive sleep apnea (OSA) surgeries may improve the quality of care. We performed a hospital-based study to compare the effectiveness and safety of two different regimens in the treatment of postoperative pain.


METHODS
A prospective, randomized, and parallel-group study.


METHODS
Ninety OSA patients were enrolled for surgical treatments in this study. Forty-five patients (group 1) were randomized to receive intravenous ketorolac and another 45 patients (group 2) were given the conventional regimen of oral mefenamic acid and intramuscular meperidine after OSA surgeries for 3 days at hospital. Postoperative discomfort was measured by a self-assessment questionnaire on the 1st and 3rd days after surgery. Any adverse effect of pain treatment was carefully monitored. Patients' satisfaction with postoperative pain treatment was evaluated 1 month postoperatively.


RESULTS
On the 1st postoperative day, group 1 patients had a significantly lower mean score in six out of eight pain-related symptoms than group 2 patients had (P<.05). At the 3rd postoperative day, significant differences remained for two symptoms. Group 1 patients were generally more satisfied with their pain treatment than were group 2 patients (P=.01). Increased risk of postoperative bleeding for group 1 was not observed in this study.


CONCLUSIONS
A short-term administration of intravenous ketorolac is noninferior to the conventional regimen and represents a safe and effective treatment for wound pain, particularly in the 1st day, after OSA surgeries in selected patients.
Department of Otolaryngology, Sleep Center, Chang Gung Memorial Hospital, and School of Medicine, Fu-Jen Catholic University, Taipei, Taiwan.
Li-Ang
LA
Lee
Pa-Chun
PC
Wang
Ning-Hung
NH
Chen
Tuan-Jen
TJ
Fang
Hao-Chun
HC
Huang
Ching-Chia
CC
Lo
Hsueh-Yu
HY
Li
D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D004564:Electrocoagulation / Q000009:adverse effects; D005260:Female; D006801:Humans; D020910:Ketorolac / Q000627:therapeutic use; D008297:Male; D008528:Mefenamic Acid / Q000627:therapeutic use; D008614:Meperidine / Q000627:therapeutic use; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000628:therapy*; D017060:Patient Satisfaction; D017286:Polysomnography; D011182:Postoperative Care; D011446:Prospective Studies; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000601:surgery*; D013997:Time Factors
D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal; D008528:Mefenamic Acid; D008614:Meperidine; D020910:Ketorolac