Postoperative pain relief with a PCA pump system for patients with head and neck cancer

Objective — to review available publications and identify unresolved issues in assessing the functional state of the oral cavity and pharynx, along with swallowing disorders in oncopathology of head and neck, depending on the treatment method. The paper discusses the problems of the extent of surgical interventions and their relationship with the possibility of maintaining the act of swallowing, and contemporary understanding of the swallowing mechanism in normal and pathological conditions. Studies on postoperative pain management and feeding techniques of cancer patients are described. Conclusion — The mechanisms of impaired swallowing after surgery and chemoradiotherapy have been analyzed. For the first time, the mechanisms of damage to swallowing have been analyzed, and the ways of overcoming pathological conditions, such as dysphagia and pain, were substantiated, with topographic and anatomical details. The perspectives of resolving the issue of nutritional status restoration were outlined.

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Effects of bio-adhesive barrier-forming oral liquid (Episil®) on pain due to radiation-induced oral mucositis in patients with head and neck cancer: A randomized crossover trial

10.21203/rs.3.rs-26692/v1 ◽

2020 ◽

Author(s):

Sakiko Soutome ◽

Souichi Yanamoto ◽

Yumiko Kawashita ◽

Masako Yoshimatsu ◽

Maho Murata ◽

...

Keyword(s):

Head And Neck Cancer ◽

Pain Relief ◽

Head And Neck ◽

Neck Cancer ◽

Oral Mucositis ◽

Crossover Trial ◽

Patient Reported ◽

Oral Liquid ◽

Radiation Induced ◽

Group B

Abstract Background Bio-adhesive barrier-forming oral liquid (Episil®) is a recently developed medical device for the management of pain caused by oral mucositis associated with cancer radiotherapy or chemotherapy. The purpose of this study was to evaluate the effectiveness of this material for the relief of pain resulting from radiation-induced oral mucositis in patients with head and neck cancer who are undergoing radiotherapy.Methods This was a randomized, open-labeled, crossover trial investigating the pain relief effects of Episil® using dexamethasone ointment as a control. Fifteen patients who had mild or moderate pain due to radiation induced oral mucositis were randomly assigned to two groups: group A applied dexamethasone ointment once on the first day, had a wash-out period on the second day, and used Episil® once on the third day. Conversely, group B used Episil® on day 1, followed by a wash-out period on day 2 and dexamethasone ointment on day 3. The effectiveness of the test drug/materials on the relief of pain was compared.Results One patient reported nausea immediately after application of Episil® and was therefore excluded from the analysis of pain relief. Dexamethasone ointment relieved pain in 85.7% of patients compared to 71.4% with Episil® (p = 0.682). Nine patients wished to continue dexamethasone ointment after the study while only five wished to continue Episil®.Conclusions Our findings suggest that the pain relief effect of Episil® is comparable to or less than that of dexamethasone ointment. Larger follow-up studies are needed to verify these findings.Trial registration:The study protocol was registered in the Japan Registry of Clinical Trials (jRCT) on March 3rd, 2019 (jRCTs072180039).

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Management of somatic pain induced by treatment of head and neck cancer: Postoperative pain. Guidelines of the French Oto-Rhino-Laryngology – Head and Neck Surgery Society (SFORL)

European Annals of Otorhinolaryngology Head and Neck Diseases ◽

10.1016/j.anorl.2014.05.002 ◽

2014 ◽

Vol 131 (4) ◽

pp. 249-252 ◽

Cited By ~ 9

Author(s):

F. Espitalier ◽

S. Testelin ◽

D. Blanchard ◽

M. Binczak ◽

M. Bollet ◽

...

Keyword(s):

Head And Neck Cancer ◽

Postoperative Pain ◽

Head And Neck ◽

Neck Cancer ◽

Neck Surgery ◽

Head And Neck Surgery ◽

Somatic Pain

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A Case of Intrathecal Pump Therapy for Intractable Head and Neck Cancer Pain

Pain Management Case Reports ◽

10.36076/pmce.2019/3/139 ◽

2019 ◽

pp. 139-144

Author(s):

Enas Kandil

Keyword(s):

Head And Neck Cancer ◽

Pain Relief ◽

Head And Neck ◽

Neck Cancer ◽

Treatment Modalities ◽

Intractable Pain ◽

Pump Therapy ◽

Oral Pain ◽

Carcinoma Of The Tongue

We present a case of a 34-year-old man who had refractory oral pain secondary to squamous cell carcinoma of the tongue and describe his status post multiple surgical procedures. After failing a variety of treatment modalities, an intrathecal pump (ITP) was placed in the lower cervical spine region. He was assessed at several points, initially every 2 weeks, then every 6 months and reported significant and continued pain relief with the ITP past the first 6-month follow-up and no neurological or respiratory side effects were noted. In addition to substantial pain relief, this invasive modality allowed the patient to be a candidate for further chemotherapeutic medications, which induced temporary remission and extended the patient’s life expectancy by over 4 months. Key words: Intrathecal pump, intractable pain, head and neck cancer

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Longitudinal Perioperative Pain Assessment in Head and Neck Cancer Surgery

Annals of Otology Rhinology & Laryngology ◽

10.1177/0003489417723034 ◽

2017 ◽

Vol 126 (9) ◽

pp. 646-653 ◽

Cited By ~ 9

Author(s):

Marisa R. Buchakjian ◽

Andrew B. Davis ◽

Sebastian J. Sciegienka ◽

Nitin A. Pagedar ◽

Steven M. Sperry

Keyword(s):

Neuropathic Pain ◽

Head And Neck Cancer ◽

Postoperative Pain ◽

Head And Neck ◽

Neck Cancer ◽

Pain Assessment ◽

Preoperative Pain ◽

Pain Diary ◽

Perioperative Pain ◽

Pain Scores

Objective: To evaluate perioperative pain in patients undergoing major head and neck cancer surgery and identify associations between preoperative and postoperative pain characteristics. Methods: Patients undergoing head and neck surgery with regional/free tissue transfer were enrolled. Preoperative pain and validated screens for symptoms (neuropathic pain, anxiety, depression, fibromyalgia) were assessed. Postoperatively, patients completed a pain diary for 4 weeks. Results: Twenty-seven patients were enrolled. Seventy-eight percent had pain prior to surgery, and for 38%, the pain had neuropathic characteristics. Thirteen patients (48%) completed at least 2 weeks of the postoperative pain diary. Patients with moderate/severe preoperative pain report significantly greater pain scores postoperatively, though daily pain decreased at a similar linear rate for all patients. Patients with more severe preoperative pain consumed greater amounts of opioids postoperatively, and this correlated with daily postoperative pain scores. Patients who screened positive for neuropathic pain also reported worse postoperative pain. Conclusion: Longitudinal perioperative pain assessment in head and neck patients undergoing surgery suggests that patients with worse preoperative pain continue to endorse worse pain postoperatively and require more narcotics. Patients with preoperative neuropathic pain also report poor pain control postoperatively, suggesting an opportunity to identify these patients and intervene with empiric neuropathic pain treatment.

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