title: Consultation with a specialized pain clinic reduces pain after oral and maxillofacial surgery.
abstract: OBJECTIVE
  Postoperative pain management is important for improved patient care. Our primary objective was to investigate the effect of analgesic treatment adaptation by the pain clinic on postoperative pain relief at an oral and maxillofacial surgery department. Additionally, we aimed to present patients' pain characteristics and the administered analgesic treatment.
  
  
  METHODS
  A total of 128 patients treated at our clinic in the period 2012-2015 who required analgesic treatment adaptation by our pain clinic were included. They were further divided into 10 groups: tumor, temporomandibular joint disorder, tooth extraction, osteomyelitis, bisphosphonate-related osteonecrosis of the jaw, submandibular abscess, orthognathic surgery, cyst, sinusitis, and fracture. Pain characteristics evaluated were intensity on a numerical rating scale (NRS) before and after intervention of the pain clinic, quality, genesis, and type.
  
  
  RESULTS
  Post treatment pain intensity values at rest 1.8 (SD: 1.4) and on exercise (walking and physical therapy) 4 (SD: 2) were statistically significant better compared to pretreatment values (4.2, SD: 2.5, and 6.8 SD: 2, respectively). The highest pain intensities were reported after tooth extractions, orthognathic surgery, cystectomies, and fracture reposition. Pain was mainly continuous and related to a combination of a somatic and a neuropathic pathophysiological mechanism.
  
  
  CONCLUSIONS
  Intervention by a specialized pain clinic leads to reduction of postoperative pain.
authors.affiliation: Department of Oral and Maxillofacial Surgery, University Hospital of Erlangen, Östliche Stadtmauerstraße 27, Erlangen, 91054, Germany. Electronic address: Eva-Maria.Dietrich@uk-erlangen.de.
authors.forename: Eva-Maria
authors.initials: EM
authors.lastname: Dietrich
authors.affiliation: Department of Anesthesiology, University Hospital of Erlangen, Östliche Stadtmauerstraße 27, Erlangen, 91054, Germany. Electronic address: Norbert.Griessinger@uk-erlangen.de.
authors.forename: Norbert
authors.initials: N
authors.lastname: Griessinger
authors.affiliation: Department of Oral and Maxillofacial Surgery, University Hospital of Erlangen, Östliche Stadtmauerstraße 27, Erlangen, 91054, Germany. Electronic address: Friedrich.Neukam@uk-erlangen.de.
authors.forename: Friedrich Wilhelm
authors.initials: FW
authors.lastname: Neukam
authors.affiliation: Department of Oral and Maxillofacial Surgery, University Hospital of Erlangen, Östliche Stadtmauerstraße 27, Erlangen, 91054, Germany. Electronic address: Tilo.Schlittenbauer@uk-erlangen.de.
authors.forename: Tilo
authors.initials: T
authors.lastname: Schlittenbauer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019647:Oral Surgical Procedures / Q000009:adverse effects*; D056948:Orthognathic Surgical Procedures / Q000009:adverse effects*; D018710:Pain Clinics; D059408:Pain Management / Q000379:methods; D010149:Postoperative Pain / Q000517:prevention & control*; D012017:Referral and Consultation; D012189:Retrospective Studies; D055815:Young Adult
keywords: Neuropathic pain; Oral cancer; Pain management; Somatic pain; WHO pain ladder