Symptoms and General Pathology

All Conditions

Neoplasms

Respiratory Tract (Lung and Bronchial) Diseases

Ear, Nose, and Throat Diseases

Nervous System Diseases

Rare Diseases

Pain, Postoperative

Pain

Head and Neck Neoplasms

Acute Pain

Laryngeal Diseases

Neurologic Manifestations

Acute Graft Versus Host Disease

Analgesics

Anticonvulsants

Central Nervous System Depressants

Psychotropic Drugs

All Drugs and Chemicals

Gabapentin

Anti-Anxiety Agents

Excitatory Amino Acid Antagonists

Neurotransmitter Agents

Gabapentin liquid by mouth or Per Tube 300mg twice a day

Placebo liquid by mouth or Per Tube twice a day

Placebo

Melanie Townsend, M.D.

Patient satisfaction with healthcare is increasingly being utilized as a metric to reflect provider and hospital quality of care. Furthermore, at the core of a healthcare team and healthcare system is the desire to provide patients with the best possible care in order to achieve the best possible outcomes. Providers have the duty to identify areas of needed improvement within the domains of treatment. An area of need that is ubiquitous within medicine is pain control; in this case acute postoperative pain control is the targeted condition. Studies have already shown that better control of acute postoperative pain leads to shortened hospital stays, reduced hospital costs and patient morbidity, improved patient satisfaction and a reduced likelihood of developing chronic pain. Research within the field of pain management has definitively revealed that a combination of different medication regimens can control acute postoperative pain better than narcotics alone. In particular, the medication gabapentin has been shown to improve acute postop pain in many kinds of surgical settings, and it is a safe medication with arguably fewer side effects than narcotics. The investigators know that certain groups of post surgical otolaryngology patients can be at risk for high levels of postoperative pain. Given all of this information, physicians have a responsibility to utilize medications such as gabapentin to do a better job of controlling patient's pain. This investigation is a quality improvement project designed to elucidate the benefits of gabapentin in pain management in patients undergoing surgery of the head and neck mucosal surfaces. It will provide much needed data in an understudied population and ultimately will improve the practice of pain management, patient satisfaction and quality of care delivered in the Barnes otolaryngology department.

Perioperative Gabapentin Use In Head And Neck Mucosal Surgery Patients

Perioperative Gabapentin Use In Head And Neck Mucosal Surgery Patients: A Randomized Clinical Trial

Total amount of narcotic use in morphine equivalents will be divided by the total hours of inpatient hospitalization, multiplied by 24 hours, to obtain the daily narcotic consumption.

-A discharge survey to document patient satisfaction and perceived pain control was given at the time of the last VAS score.

* Subjective pain scores were captured using the Visual Analog Scale (VAS). Subjects were asked to "Please rate your current pain level with no movement (rest), with a cough, and with a swallow". Subjects marked a point on a 100-mm line anchored "no pain" on the left end and "worst possible pain" on the right end.
* Pain literature reports that scores in the 10-30mm range correlate clinically with mild pain, in the 30-60 or 70mm range with moderate pain, and in the \>70 range with severe pain

Washington University School of Medicine

Gabapentin liquid by mouth or per Tube 300mg twice a day

Total

Age, Continuous

Sex: Female, Male

Race and Ethnicity were not collected from any participant.

Race and Ethnicity Not Collected

United States

Region of Enrollment

Low effectiveness

High effectiveness

Some participants were not included as they had never had narcotic pain medication prior to surgery.

Participant's opinion on effectiveness of narcotic pain medication

Participants were asked about daily pain aside from the pain due to the current head and neck condition.

3 responses are missing because surveys were not given (1 in the gabapentin arm and 2 in the placebo arm)

Participant's experience with significant amount of daily pain

All subjects were analyzed following intention to treat principles and were included in the final analysis if greater than one night of admission was achieved before study participation ended.

Change in Daily Narcotic Consumption

The participants who did not answer this question on the survey were not evaluable for this outcome measure.

Patient Reported Post-treatment Pain Satisfaction as Measured by How Often the Participant's Pain Was Well Controlled

Patient Reported Post-treatment Pain Satisfaction as Measured by How Often the Hospital Staff Did Everything They Could do to Help the Participant's Pain

Patient Reported Post-treatment Pain Satisfaction as Measured by Overall Pain Control

Post-operative Day 1 7AM

Post-operative Day 1 10AM

Post-operative Day 1 7PM

Post-operative Day 2 7AM

Post-operative Day 2 10AM

Post-operative Day 2 7PM

Post-operative Day 3 7AM

Mean Pain With Resting Score as Measured by VAS

Mean Pain With Coughing Score as Measured by VAS

This statistical analysis is for the mean difference between the 2 arms at Post-Operative Day 2 7AM.

Spots Global Cancer Trial Database for hypopharynx and larynx