Effectiveness of NonOpioid/NonNarcotic Post-Operative Pain Management Regimen for Patients Undergoing Thyroidectomy and/or Parathyroidectomy

  • Background / Purpose:
    To evaluate the effectiveness of a non-opioid/non-narcotic pain management regimen used to treat post operative pain in patients undergoing thyroidectomy and/or parathyroidectomy.

    Methods:
    Patients undergoing thyroidectomy and/or parathyroidectomy preformed by our department during the time interval of April 2017 thru July 2018 receiving cutaneous injection with bupivacaine (0.5% bupivacaine hydrochloride with epinephrine, 1:200,000)  administered prior to incision, and discharged with oral acetaminophen and ibuprofen (ibuprofen added to regimen on postoperative day two) represented the study population. Response to pain management was evaluated using a scaled standard medical pain assessment tool via verbal questionnaire at patients postoperative visit, 7-10 days post procedure.

    Results:
    In total, 240 procedures were performed over the study period (177 thyroidectomy, 63 parathyroidectomy). Seventeen patients were excluded from the study due to preoperative chronic opioid therapy for an unrelated diagnosis. 223 patients (166 thyroidectomy, 57 parathyroidectomy) were included in the study. Of these, only 5 required an oral opioid/narcotic prescription for post surgical pain. On follow up, the remaining 218 patients (97.76%) reported adequate pain control with the prescribed regimen, and required no opioid/narcotic supplementation.

    Conclusion:
    Pre-incision cutaneous injection of bupivacaine, coupled with oral acetaminophen and ibuprofen, provides adequate pain control post operatively in patients undergoing thyroidectomy and/or parathyroidectomy, therefore avoiding opioid/narcotic supplementation. 

 

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