ORIGINAL ARTICLE   

Otorhinolaryngology 2022 March;72(1):15-20

DOI: 10.23736/S2724-6302.20.02321-8

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

Factors associated with moderate to severe pain during the first 24 hours after modified uvulopalatopharyngoplasty: a retrospective study

Nattaya RAYKATEERAROJ ¹, Saowapark CHUMPATHONG ¹ ✉, Nuanprae KITISIN ¹, Bharadee TEERAVIDJA ¹, Wish BANHIRAN ²

¹ Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand; ² Department of Oto-Rhino-Laryngology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand

BACKGROUND: Uvulopalatopharyngoplasty (UPPP) is an extensive airway surgery for obstructive sleep apnea (OSA) patients causing considerable perioperative pain. The OSA patients usually receive inadequate pain control due to the risk of opioid-induced respiratory depression, and the risk of postoperative bleeding from nonsteroidal anti-inflammatory drugs (NSAIDs) usage. Hence, this study aimed to identify the risk factors associated with postoperative pain. Thereby, an effective pain management strategy can be developed.
METHODS: This retrospective study included patients who had underwent modified UPPP from April 2012 to December 2017. Patient factors, anesthetic factors, surgical factors, pain score at the Postanesthesia Care Unit, and in the first 24-hour postoperative were collected and analyzed.
RESULTS: In total, 190 patients were included. The mean age was 38.7±11.3 years old and the mean Body Mass Index (BMI) was 24.0±4.7 kg/m², and 91.6% of patients were male. The incidence of moderate (Visual Analog Scale Score [VAS] of 4-6 out of 0-10) to severe pain (VAS≥7) during the first 24 hours after the modified UPPP was 32.6%. Multivariate analysis revealed that radiofrequency (RF) turbinate reduction (odds ratio [OR]=1.98; 95% Confidence Interval (CI): 1.04-3.771) and every additional 50 mL of bleeding (OR=1.36, 95% CI: 1.02-1.831) were associated with moderate to severe pain during the first 24 hours postoperative.
CONCLUSIONS: The incidence of moderate to severe pain during the first 24 hours after the modified UPPP was 32.6% and the significant risk factors were intraoperative blood loss and radiofrequency turbinate reduction.

KEY WORDS: Sleep apnea syndromes; Pharynx; Surgery; Postoperative period; Turbinates; Risk factors