Treatment of pain after head and neck surgeries: Control of acute pain after head and neck oncological surgeries

Objective: To devise an effective postoperative analgesic protocol. Study design and setting: Two consecutive groups participated in this study. In the first group (n = 100), the pain-control management was pro re nata (PRN). In the second group, (n = 109) we tailored a procedure-specific pain-control protocol for each patient according to the level of pain recorded in the first group. These patients were treated with analgesics given at predetermined hours. Pain was evaluated by using a verbal scale of 1 to 10. Results: In the first group, a significant reduction in the level of pain was monitored 1 hour after PRN drug administration; however, patients reported the return of pain several hours later, after the drug effect subsided. Overall, the patients suffered a substantial level of pain during the entire postoperative period. In the second group, significant reduction in the level of pain was recorded throughout the hospitalization. Conclusion: The PRN protocol is not adequate for management of pain after head and neck surgeries. Significance: We can substantially reduce our patients' postoperative pain by adopting a procedure-specific analgesic regimen instead of a PRN regimen. EBM rating: B-3b.