title: Healthcare usage after uvulopalatopharyngoplasty - Impact of analgesic regimen.
abstract: OBJECTIVE
  1) Analyze differences in healthcare usage between subjects receiving different perioperative analgesic medications after uvulopalatopharyngoplasty (UPPP) surgery. 2) Comment on the impact of perioperative analgesic medication on length of hospital stay and complications after UPPP.
  
  
  METHODS
  A retrospective cohort study of 120 UPPPs conducted by a single surgeon in the past 5years was conducted. Subjects were grouped based on perioperative pain medication regimen into three groups; narcotics alone (n=83), narcotics with gabapentin (n=27), or narcotics with ketorolac tromethamine (n=10). The primary outcome variable was total number of clinic/emergency room and/or telephone encounters related to post-UPPP pain. Secondary outcomes included length of post-operative hospital stay, number of telephone and/or clinical encounters in which the patient complained specifically of pain or requested a refill for analgesics, and post-operative complications.
  
  
  RESULTS
  No significant difference was found between the three analgesic regimens in post-operative hospital stay length (p=0.28, median stay 23.5h), number of clinic or telephone encounters related to pain (p=0.26, mean value 0.71 encounters), or post-operative complication rate (p=0.82, 5.9% complication rate).
  
  
  CONCLUSIONS
  This study shows no significant difference in post-operative healthcare usage between patients with peri-operative analgesic regimens including narcotics alone, gabapentin with narcotics, or ketorolac with narcotics. Post-operative complication rate and length of stay did not differ between groups. These data suggest that these three medication regimens have similar impact on post-operative course for UPPP patients. Therefore, the most affordable or simplest options have equivalent effects on post-operative healthcare usage.
authors.affiliation: The Cleveland Clinic Head and Neck Institute, 9500 Euclid Avenue/A71, Cleveland, OH 44195, United States. Electronic address: tiernew@ccf.org.
authors.forename: William S
authors.initials: WS
authors.lastname: Tierney
authors.affiliation: The Cleveland Clinic Head and Neck Institute, 9500 Euclid Avenue/A71, Cleveland, OH 44195, United States.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Gabarain
authors.affiliation: The Cleveland Clinic Head and Neck Institute, 9500 Euclid Avenue/A71, Cleveland, OH 44195, United States.
authors.forename: Alan H
authors.initials: AH
authors.lastname: Kominsky
mesh_terms: D000328:Adult; D000700:Analgesics / Q000627:therapeutic use*; D017723:Drug Utilization Review; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D059408:Pain Management / Q000379:methods*; D010149:Postoperative Pain / Q000188:drug therapy*; D010160:Palate, Soft / Q000601:surgery; D010614:Pharynx / Q000601:surgery; D012189:Retrospective Studies; D020181:Sleep Apnea, Obstructive / Q000601:surgery*; D016896:Treatment Outcome; D014609:Uvula / Q000601:surgery
chemical_list: D000700:Analgesics
keywords: Analgesia; Bleeding; Complications; Outcomes; Post-operative pain; Sleep apnea; Sleep surgery; UPPP; Uvulopalatopharyngoplasty