Patient Satisfaction With Postoperative Nonopioid Analgesia: A Randomized Trial

Introduction: Studies have shown that patients undergoing ambulatory head and neck surgery experience mild to moderate levels of pain and often do not require opioid therapy. Several studies have demonstrated successful decrease in opioid prescriptions and effective non-opioid analgesia. The purpose of this study is to assess patient satisfaction with non-opioid analgesia in the post-operative period.

Methods: A randomized prospective trial was conducted at a tertiary care university setting. (NCT04976387) Adult patients who underwent outpatient head and neck surgery were randomized to receive one of the following primary analgesic therapy following surgery: 1) hydrocodone-acetaminophen; 2) ibuprofen; 3) ibuprofen and acetaminophen combination therapy. Patients completed a validated questionnaire at their first follow-up visit.

Results: 104 patients had complete post-operative questionnaire (mean age, 51.2 years; female 74%). The mean satisfaction score with the pain regimen received was similar between all three groups (scale 1-5, [3.5, 4.1, 4.0, p-value 0.205]). The three groups also had similar perception of surgery being more painful than anticipated (27.6%, 28.6%, 22.9%, p-value 0.978), and felt willing to repeat the same regimen for future surgeries (75.9%, 83.3%, 71.4%, p-value 0.682). Additional questions evaluating side effect profile, maximum and minimum pain, and difficulty of recovery were not statistically different between the three groups.

Conclusions: Non-opioid therapy is effective for pain management following outpatient head and neck surgery. Not only were there no significant difference in pain control between groups who used opioid and non-opioid therapy, but patients had similar satisfaction levels with their analgesic therapy. Patients who received non-opioid therapy also expressed willingness to utilize similar regimen following future surgeries.