title: Factors Associated With the Use of Postoperative Analgesics in Patients Undergoing Direct Microlaryngoscopy.
abstract: OBJECTIVE
  Morbidity associated with suspension laryngoscopy has been well documented. However, standard of care with regard to postoperative analgesia has not been described, and anecdotal evidence suggests wide variability with regard to postoperative narcotic and non-narcotic recommendations. We sought to quantify the postoperative course following suspension microlaryngoscopy by relating patient-based and intraoperative measures with analgesic use.
  
  
  METHODS
  Body mass index (BMI), Friedman tongue position (FTP), and Mallampati scores as well as laryngoscope type, number of attempts required for optimal visualization, and suspension time were documented in 50 consecutive patients undergoing routine suspension microlaryngoscopy. Postoperative symptoms and analgesic use was queried on postoperative days 1, 3, and 10.
  
  
  RESULTS
  In this cohort, 62.5% employed postoperative analgesia. However, only 20% required narcotics. No difference in suspension time was identified in those taking analgesics (33.0 vs 37.3 minutes, P = .44). In addition, no relationship between procedure type and the need for analgesia was noted. The majority of patients (76%) described sore throat persisting for 3 postoperative days; 36% reported sore throat persisting beyond postoperative day 3.
  
  
  CONCLUSIONS
  The majority of patients undergoing microlaryngoscopy reported discomfort, but symptoms were largely ameliorated with over-the-counter analgesics. Routine prescription of narcotics following routine suspension laryngoscopy may be unnecessary.
authors.affiliation: 1 NYU Voice Center, Department of Otolaryngology-Head and Neck Surgery, New York University School of Medicine, New York, New York, USA.|2 ENT and Allergy Associates, New York, New York, USA.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Taliercio
authors.affiliation: 1 NYU Voice Center, Department of Otolaryngology-Head and Neck Surgery, New York University School of Medicine, New York, New York, USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Sanders
authors.affiliation: 1 NYU Voice Center, Department of Otolaryngology-Head and Neck Surgery, New York University School of Medicine, New York, New York, USA.
authors.forename: Stratos
authors.initials: S
authors.lastname: Achlatis
authors.affiliation: 3 Department of Population Health, New York University School of Medicine, New York, New York, USA.
authors.forename: Yixin
authors.initials: Y
authors.lastname: Fang
authors.affiliation: 1 NYU Voice Center, Department of Otolaryngology-Head and Neck Surgery, New York University School of Medicine, New York, New York, USA.
authors.forename: Ryan
authors.initials: R
authors.lastname: Branski
authors.affiliation: 1 NYU Voice Center, Department of Otolaryngology-Head and Neck Surgery, New York University School of Medicine, New York, New York, USA.
authors.forename: Milan
authors.initials: M
authors.lastname: Amin
mesh_terms: D000328:Adult; D000368:Aged; D000700:Analgesics / Q000145:classification / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007828:Laryngoscopy / Q000009:adverse effects / Q000379:methods; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D059408:Pain Management / Q000379:methods; D010147:Pain Measurement / Q000379:methods; D010149:Postoperative Pain / Q000175:diagnosis / Q000188:drug therapy; D013997:Time Factors
chemical_list: D000700:Analgesics
keywords: Friedman tongue position; analgesia; body mass index; direct laryngoscopy; narcotic; phonomicrosurgery; suspension laryngoscopy; voice