xRead - Nasal Obstruction (September 2024) Full Articles

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550

International consensus statement on rhinosinusitis

effective in

providing analgesia when performed

intraoperatively.

consideration in

multi-modality pain control.

patients who do not have intolerance,

kidney dysfunction.

consideration to use intraoperatively.

Benefit- Harm Assessment Value Judgments Policy Level Intervention Preponderance of benefit over harm Safe, effective, low cost analgesic for PO formulation. Recommend PO formulation First line PO analgesia in post-operative patients.

Option Canbea

Option Analgesia option in

Option Canbea

Recommend Easy, quick, and

Intraoperative nerve blocks are effective, safe,

reliable method to control

postoperative pain.

Reduces pain scores and need for other analgesics, but

there is potential for drowsiness.

Effective, low cost analgesic, but

should not be used in intolerant patients.

relative to the cost; pain benefit is short lived.

Off label indication;

Value is limited

Low Preponderance of benefit over harm

Moderate Balance of benefit andharm

Low Balance of benefit andharm

High Balance of benefit andharm

High for IV

TABLE XII-3 Summary of evidence for perioperative pain management Analgesic Type Aggregate Grade Benefit Harm Cost Acetaminophen B (Level 2: 3 studies, Level 3: 1 study) Safe analgesic, effectively controls postoperative pain and reduces need for opioids. GI upset, toxicity ( > 3000mg) LowforPO, NSAIDs A (Level 2: 7 studies, Level 3: 1 study) Safe, analgesic, effectively controls postoperative pain and reduces need for opioids. Interferes with platelet function and bleeding time. NSAID intolerance in

local irritation,

edema, toxicity (4.5m/kg)

drowsiness,

headache, nausea,

vomiting,

patients with AERD.

May exacerbate kidney

dysfunction.

hypotension

bradycardia,

drymouth.

Minimal risk –

Dizziness,

Minimal risk

As a peripheral nerve block- reduces need

for opioid analgesia. When soaked in a topical nasal

pack-effectively

reduces pain and

enhances comfort.

Effective in chronic pain, can help reduce opioid

analgesic use

postoperatively.

Provides sedation, anxiolysis, and

analgesia without

causing respiratory depression

studies, Level 3: 3 studies)

Gabapentinoids A (Level 2: 4 studies)

Alpha-2 Agonists B (Level 2: 5 studies, Level 3: 3 studies)

Local anesthetics B (Level 2: 9