Postoperative Pain Profile After Major Cervicofacial Cancer Surgery

Abstract

Background: Despite its anticipation, postoperative pain may be still poorly managed in some cases, such as in patients undergoing major cervicofacial cancer surgery. Indeed, the postoperative pain associated with these surgeries is complex and multifactorial. Objective: To assess the profile of postoperative pain scores and opioid requirements in a cohort of consecutive patients undergoing major cancer cervicofacial surgery with or without reconstruction. Methods: A cohort of 42 consecutive patients was studied. The following parameters were recorded: patients characteristics, type of surgery, preoperative medication preoperative pain scores, and postoperative pain score (5-point numerical verbal scale) upon arrival at the postanesthesia care unit (PACU) and at Day 1 to Day 7 (11-point visual numeric scale), the presence or absence of neuropathic and/or chronic pain one year later (determined by a phone interview), and morphine consumption. Results: All patients had a pain score of less than 3 in the PACU. From postoperative day 1 to day 7, pain scores were extremely variable and stayed high or even increased up to 7 in many patients. At the one-year phone interview, some patients had neuropathic and chronic pain.Discussion: Postoperative pain profiles in major cervicofacial cancer are complex, with high interindividual variability and with cases with neuropathic patterns and high pain scores that can last up to 7 days postoperatively.