TY - JOUR

T1 - Transoral robotic surgery–time for consensus on pain assessment. A review

AU - Larsen, Mikkel Hjordt Holm

AU - Kehlet, Henrik

AU - von Buchwald, Christian

N1 - Publisher Copyright: © 2023 Acta Oto-Laryngologica AB (Ltd).

PY - 2023

Y1 - 2023

N2 - Background: In Head and Neck surgery Transoral Robotic Surgery (TORS) is evolving as a key treatment option for benign and malignant lesions in the oropharynx. Even so, postoperative pain is one of the primary early complaints following TORS. Well established evidence-based procedure specific pain treatment guidelines are available for a variety of other surgical specialties. However, there are no guidelines for TORS Aim: This review describes the available data of early pain intensity following TORS during rest and procedure related activity. Methods: Literature concerning pain in the immediate postoperative phase following TORS were obtained from two literature databases Results: Most data on pain intensity following TORS are based upon a numeric rating scale, e.g. the Visual Analogue Scale and/or analgesic demands. Only one randomized clinical trial is available reflecting that the literature is mainly based on retrospective and a few prospective studies. Only one study analyzed pain during relevant functionality, i.e. swallowing. Overall, the studies suffer from a non-standardized approach and there is a need for transparent information concerning the timing of pain ratings and methodology Conclusions: The evidence for optimal pain control is limited, particularly during surgical relevant activity. Postoperative pain rating during activity is a fundamental element in pain trials in order to enhance recovery thereby calling for future consensus on assessment methodology.

AB - Background: In Head and Neck surgery Transoral Robotic Surgery (TORS) is evolving as a key treatment option for benign and malignant lesions in the oropharynx. Even so, postoperative pain is one of the primary early complaints following TORS. Well established evidence-based procedure specific pain treatment guidelines are available for a variety of other surgical specialties. However, there are no guidelines for TORS Aim: This review describes the available data of early pain intensity following TORS during rest and procedure related activity. Methods: Literature concerning pain in the immediate postoperative phase following TORS were obtained from two literature databases Results: Most data on pain intensity following TORS are based upon a numeric rating scale, e.g. the Visual Analogue Scale and/or analgesic demands. Only one randomized clinical trial is available reflecting that the literature is mainly based on retrospective and a few prospective studies. Only one study analyzed pain during relevant functionality, i.e. swallowing. Overall, the studies suffer from a non-standardized approach and there is a need for transparent information concerning the timing of pain ratings and methodology Conclusions: The evidence for optimal pain control is limited, particularly during surgical relevant activity. Postoperative pain rating during activity is a fundamental element in pain trials in order to enhance recovery thereby calling for future consensus on assessment methodology.

KW - Pain

KW - recovery

KW - transoral robotic surgery

U2 - 10.1080/00016489.2023.2282149

DO - 10.1080/00016489.2023.2282149

M3 - Review

C2 - 37991140

AN - SCOPUS:85177595514

VL - 143

SP - 902

EP - 911

JO - Acta Oto-Laryngologica

JF - Acta Oto-Laryngologica

SN - 0001-6489

IS - 10

ER -