Laryngeal force sensor metrics are predictive of increased perioperative narcotic requirements.

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Tytuł:: Laryngeal force sensor metrics are predictive of increased perioperative narcotic requirements.
Autorzy:: Feng AL; Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts, U.S.A.; Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, U.S.A.
Ciaramella A; Department of Anesthesiology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, U.S.A.
Naunheim MR; Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts, U.S.A.; Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, U.S.A.
Gadkaree SK; Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts, U.S.A.; Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, U.S.A.
Fat I; Department of Anesthesiology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, U.S.A.
Song PC; Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts, U.S.A.; Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, U.S.A.
Źródło:: The Laryngoscope [Laryngoscope] 2019 Nov; Vol. 129 (11), pp. 2563-2567. Date of Electronic Publication: 2019 Jan 22.
Typ publikacji:: Journal Article; Observational Study
Język:: English
Imprint Name(s):: Publication: <2009- >: Philadelphia, PA : Wiley-Blackwell
Original Publication: St. Louis, Mo. : [s.n., 1896-
MeSH Terms:: Intraoperative Neurophysiological Monitoring/*statistics & numerical data
Laryngoscopy/*adverse effects
Microsurgery/*adverse effects
Narcotics/*therapeutic use
Pain, Postoperative/*drug therapy
Aged ; Female ; Humans ; Laryngoscopy/methods ; Larynx/surgery ; Male ; Microsurgery/methods ; Middle Aged ; Morphine/therapeutic use ; Pain, Postoperative/etiology ; Predictive Value of Tests ; Pressure ; Prospective Studies ; Stress, Mechanical
References:: Hagemeier NE. Introduction to the opioid epidemic: the economic burden on the healthcare system and impact on quality of life. Am J Manag Care 2018;24:S200-S206.
Substance Abuse and Mental Health Services Administration. Results from the National Survey on Drug Use and Health. Available at: https://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabs-2016/NSDUH-DetTabs-2016.pdf. Accessed October 10, 2018.
Kochanek KD, Murphy SL, Xu J, Arias E. Mortality in the United States, 2016. Available at: https://www.cdc.gov/nchs/data/databriefs/db293.pdf. Accessed October 10, 2018.
Mahboubi H, Verma SP. Ambulatory laryngopharyngeal surgery: evaluation of the national survey of ambulatory surgery. JAMA Otolaryngol Head Neck Surg 2013;139:28-31.
Rosen CA, Andrade Filho PA, Scheffel L, Buckmire R. Oropharyngeal complications of suspension laryngoscopy: a prospective study. Laryngoscope 2005;115:1681-1684.
Tessema B, Sulica L, Yu GP, Sessions RB. Tongue paresthesia and dysgeusia following operative microlaryngoscopy. Ann Otol Rhinol Laryngol 2006;115:18-22.
Corvo MAdA, Inacio A, Mello MBdC, Eckley CA, Duprat AdC. Extra-laryngeal complications of suspension microlaryngoscopy. Rev Bras Otorrinolaringol 2007;73:727-732.
Landis BN, Giger R, Dulguerov P, Hugentobler M, Hummel T, Lacroix JS. Gustatory function after microlaryngoscopy. Acta Otolaryngol 2007;127:1086-1090.
Rucci L, Romagnoli P, Scala J. CO(2) laser therapy in Tis and T1 glottic cancer: indications and results. Head Neck 2010;32:392-398.
Olthoff A. Surgery of benign vocal fold lesions [in German]. HNO 2016;64:683-694.
Orosco RK, Lin HW, Bhattacharyya N. Safety of adult ambulatory direct laryngoscopy: revisits and complications. JAMA Otolaryngol Head Neck Surg 2015;141:685-689.
Feng AL, Song PC. Laryngeal force sensor: quantifying extralaryngeal complications after suspension microlaryngoscopy. Otolaryngol Head Neck Surg 2018;159:328-334.
Han B, Compton WM, Jones CM, Cai R. Nonmedical prescription opioid use and use disorders among adults aged 18 through 64 years in the United States, 2003-2013. JAMA 2015;314:1468-1478.
Centers for Disease Control and Prevention. Annual surveillance report of drug-related risks and outcomes. Available at: https://www.cdc.gov/drugoverdose/pdf/pubs/2017-cdc-drug-surveillance-report.pdf. Accessed October 10, 2018.
Nelson LS, Juurlink DN, Perrone J. Addressing the opioid epidemic. JAMA 2015;314:1453-1454.
Schwartz MA, Naples JG, Kuo CL, Falcone TE. Opioid prescribing patterns among otolaryngologists. Otolaryngol Head Neck Surg 2018;158:854-859.
Sun EC, Darnall BD, Baker LC, Mackey S. Incidence of and risk factors for chronic opioid use among opioid-naive patients in the postoperative period. JAMA Intern Med 2016;176:1286-1293.
Namba RS, Singh A, Paxton EW, Inacio MCS. Patient factors associated with prolonged postoperative opioid use after total knee arthroplasty. J Arthroplasty 2018;33:2449-2454.
Shen SA, Jafari A, Bracken D, Pang J, DeConde AS. Predictive value of SNOT-22 on additional opiate prescriptions after endoscopic sinus surgery. Int Forum Allergy Rhinol 2018;8:1021-1027.
Pang J, Tringale KR, Tapia VJ, et al. Chronic opioid use following surgery for oral cavity cancer. JAMA Otolaryngol Head Neck Surg 2017;143:1187-1194.
Feng AL, Razavi CR, Lakshminarayanan P, et al. The robotic ENT microsurgery system: a novel robotic platform for microvascular surgery. Laryngoscope 2017;127:2495-2500.
Feng AL, Clark JH, Agrawal N, Moussa W, Richmon JD. Neck incision planning for total laryngectomy: a finite element analysis. J Biomech 2015;48:4149-4154.
Clark JH, Feng AL, Morton K, Agrawal N, Richmon JD. Neck incision planning for total laryngectomy with pharyngectomy. Otolaryngol Head Neck Surg 2016;154:650-656.
Contributed Indexing:: Keywords: Equipment design; device design; force sensor; laryngology; laryngoscopy; narcotics; opioid epidemic; suspension microlaryngoscopy
Substance Nomenclature:: 0 (Narcotics)
76I7G6D29C (Morphine)
Entry Date(s):: Date Created: 20190123 Date Completed: 20191107 Latest Revision: 20200108
Update Code:: 20240105
DOI:: 10.1002/lary.27827
PMID:: 30667084
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Objectives/hypothesis: To determine the relationship between force metrics measured by the laryngeal force sensor (LFS) during suspension microlaryngoscopy (SML) and perioperative narcotic requirements.
Study Design: Prospective observational study.
Methods: Compressive tissue forces were recorded during SML using the LFS and correlated with postoperative narcotic requirements in the postanesthesia care unit (PACU) at an academic tertiary center. Patients were prospectively enrolled and had force metrics recorded throughout each procedure including maximum force, average force, suspension time, and total impulse. Narcotic administration in the intraoperative period and PACU were also recorded and converted into intravenous morphine equivalents (ME). Surgeons were blinded to the force recordings during surgery to prevent operator bias.
Results: Eighty-two patients completed the study. Of these patients, the mean perioperative ME requirement was 16.96 mg (range, 0.15-79.82 mg). Univariate analysis demonstrated a positive correlation between perioperative narcotic requirements and total suspension time (P < .001) as well as total impulse (P = .007). A positive correlation was also seen with maximum force, although not significantly. On multiple linear regression, total suspension time was a significant predictive variable for perioperative narcotic use, with a marginal incremental increase of 0.273 mg of ME per minute of total suspension time (0.273 mg/min, 95% confidence interval: 0.040-0.507 mg/min, P = .022).
Conclusions: Intraoperative force metrics including total suspension time are predictive of increased perioperative narcotic requirement after SML. Total impulse during SML may also correlate with increased perioperative narcotic requirements.
Level of Evidence: 2 Laryngoscope, 129:2563-2567, 2019.
(© 2019 The American Laryngological, Rhinological and Otological Society, Inc.)

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