Pain management after thyroidectomy: are opioids needed?

  • Papoian V & al.
  • Surgery
  • 17 Mar 2020

  • curated by Kelli Whitlock Burton
  • Clinical Essentials
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Takeaway

  • Patients who received nonopioid medication for pain after thyroidectomy had pain scores similar to those who received an opioid at times ranging from 1 hour after surgery to the first follow-up office visit.

Why this matters

  • Postoperative pain management following thyroidectomy often includes prescription opioids, even though research suggests post-thyroidectomy may not require opioids to control pain.

Study design

  • A 2-arm, nonblinded randomized study of 95 patients (age ≥18 years) who underwent thyroidectomy during 2018-2019.
  • Outcomes: pain scores based on the visual analog scale and opioid use during the postoperative care period.
  • Funding: None.  

Key results

  • Patients who received nonopioid medication vs those who received opioids showed no significant difference for pain scores:
    • 1 hour after the operation (3.3±2.8 vs 3.9±2.8; P=.35).
    • 6 hours after the operation (2.8±2.1 vs 3.0±3.0; P=.08).
    • On postoperative day 1 (1.6±2.2 vs 2.4±2.5; P=.08).
    • On first office visit (0.2±0.8 vs 0.1±0.6; P=.82).
  • Morphine-equivalent opioid requirement for pain control in the postoperative period was significantly lower (0.8 vs 6.9 mg; P<.01>

Limitations

  • Comparison of only 2 specific methods.
  • Nonopioid pain control is not feasible for every patient.
  • Single-center study.

Coauthored by Vijay Rathod, PhD.