Depression and female gender associated with higher postoperative pain scores after sinonasal surgery

Abstract

Background

Although it is extremely necessary to reduce the number of opioids taken postoperatively after sinonasal surgery, this is the subject of controversial discussion.

Objectives

The objective of this study was to identify factors that predict higher postoperative pain scores (PPS) and the need for opioid analgesics after sinonasal surgery.

Material and methods

This was a retrospective study of n = 492 patients who underwent functional endoscopic sinus surgery (FESS), septoplasty or a combination of both in the Otolaryngology Department in Erlangen between January and December 2018. Postoperative pain using the numeric rating scale and the postoperative need for non-opioid and opioid analgesics in relation to demographic and surgical parameters were evaluated.

Results

Significant predictors for a higher pain score were depression (p = .009) and female gender (p < .001). A significant predictor of the need for postoperative opioids was the female gender (p < .001), whereas FESS alone showed a significantly lower need for opioids (p = .035) and a significantly lower PPS compared to septoplasty (p < .001).

Conclusions and significance

The study identified risk factors for a higher PPS and the need for opioids. The results indicated that reducing postoperative opioids might be possible in patients without these risk factors and might help guide individualized postoperative therapy.

Chinese Abstract

背景：虽然在鼻腔鼻窦手术后减少阿片类药物的用量是非常必要的, 但这是一个有争议的话题。

目的：本研究的目的是确定预测术后较高的疼痛评分（PPS）的因素, 以及鼻窦手术后对阿片类镇痛药的需求。

材料和方法：这是一项对492 名2018 年 1 月至 12 月期间在Erlangen 的耳鼻喉科接受功能内窥镜鼻窦手术治疗(FESS) 、鼻中隔成形术或这两项的组合手术的患者进行的回顾性研究。评估了数字型等级量表的术后疼痛和与人口统计学和手术参数相关的术后对非阿片类和阿片类镇痛药的需求。

结果：较高疼痛评分的重要预测因素是抑郁症 (p = .009) 和女性性别(p < .001)。术后阿片类药物需求的一个重要预测因素是女性性别(p < .001)；而与隔膜成形术相比, 单独的 FESS手术显示对阿片类药物的需求显著较低 (p = .035), PPS 显著较低 (p < .001)。

结论和意义：该研究确定了更高的 PPS 和需要用阿片类药物的风险因素。结果表明, 对于没有这些危险因素的患者, 减少术后阿片类药物的使用是可能的, 并且可能有助于规划个体化术后治疗。

Keywords:

• Postoperative pain
• depression
• female
• sinonasal surgery
• opioid analgesics

Acknowledgments

Firstly, I would like to thank my colleague and research supervisor for her continuous support, patience, motivation, as well as provided ideas and lovely guidance. I would like to thank her doctoral student for his diligence and efforts. Furthermore, I would like to thank all my colleagues for their support and encouragement and our chief physician for giving us the opportunity to do research.

Disclosure statement

No potential conflict of interest was reported by the authors.