Prevalence and predictors of postoperative pain after ear, nose, and throat surgery

Objective To determine postoperative pain in different types of ear, nose, and throat (ENT) surgery and their psychological preoperative predictors. Design Prospective cohort study. Setting Academic hospital. Patients A total of 217 patients undergoing ENT surgery. Interventions All ENT, neck, and salivary gland surgery. Main Outcome Measures Postoperative pain and predictors for postoperative pain. Results Fifty percent of the patients undergoing surgery on the oral, pharyngeal, and laryngeal region and on the neck and salivary gland region had a visual analog scale score higher than 40 mm on day 1. In the patients who underwent oropharyngeal region operations the VAS score remained high on all 4 days. A VAS pain score higher than 40 mm was found in less than 30% of patients after endoscopic procedures and less than 20% after ear and nose surgery. After bivariate analysis, 6 variables–age, sex, preoperative pain, expected pain, short-term fear, and pain catastrophizing–had a predictive value. Multivariate analysis showed only preoperative pain, pain catastrophizing, and anatomical site of operation as independent predictors. Conclusions Differences exist in the prevalence of unacceptable postoperative pain between ENT operations performed on different anatomical sites. A limited set of variables can be used to predict the occurrence of unacceptable postoperative pain after ENT surgery.