Perioperative pain management for thyroid and parathyroid surgery: A systematic review

Am J Surg. 2022 Apr;223(4):641-651. doi: 10.1016/j.amjsurg.2021.06.017. Epub 2021 Jul 8.

Abstract

Introduction: A growing body of evidence suggests that surgeons have historically over-prescribed opioid pain medications following thyroid and parathyroid surgery, thereby potentially contributing to the current US opioid epidemic. We reviewed the evidence supporting multimodal methods of pain control after cervical endocrine surgery.

Methods: Fifty-one randomized clinical trials, 9 prospective cohort studies, 7 retrospective studies/reviews, and 1 survey regarding pain management for cervical endocrine surgery were include.

Results: Most studies reported in-hospital pain scores and opioid consumption. Data on pain scores following discharge were limited. In several studies, the interventional dose was much greater than what is commonly used clinically.

Conclusion: Several evidence-based, non-opioid interventions can be incorporated into a standardized pain management protocol following cervical endocrine surgery. Little is known regarding the effects of these interventions on post-discharge pain scores and patient quality of life during recovery.

Keywords: Cervical endocrine surgery; Multimodal pain control; Opioids.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Aftercare
  • Analgesics, Opioid* / therapeutic use
  • Humans
  • Pain Management* / methods
  • Pain, Postoperative / drug therapy
  • Pain, Postoperative / prevention & control
  • Patient Discharge
  • Prospective Studies
  • Quality of Life
  • Retrospective Studies
  • Thyroid Gland

Substances

  • Analgesics, Opioid