Assessment of Pain after Ear Surgery

By June 7, 2019

Ronner, Evette1; Benchetrit, Liliya2; Caloway, Christen1; Kempfle, Judith1; Cohen, Michael1.
1 Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, MA;
2 Yale School of Medicine, New Haven, CT.

To determine the feasibility of assessing postoperative pain and medication use following middle ear surgery using an electronic survey.

Study Design:
Prospective longitudinal study. Surveys were administered upon discharge to caregivers of pediatric patients undergoing middle ear surgery between 5/2018 to 3/2019. Pain intensity and medication use was recorded twice daily for six days, beginning on postoperative day 0. The Wong-Baker FACES® Pain Rating Scale was utilized to evaluate pain levels. Parents reported the frequency and dosage of pain medications administered.
Setting: Tertiary care center
Patients: Pediatric patients undergoing ear surgery
Intervention: Electronic survey tool

Main outcome measure:
Reported pain
Results: Survey response rate was 54%. Among the 14 patients who completed the survey, 7 (50%) were male and average age was 7.5 years. 10 (71%) children underwent transcanal endoscopic surgery. The average pain rating across all six days was 2 (SD 1.45). 9 patients required acetaminophen only to manage pain and 1 (7%) took oxycodone. 8 (57%) patients took no medication following postoperative day 2 and no patients required medication after post-op day five. Medication use was moderately correlated with pain ratings (r = 0.63, p < .05). On average, patients who underwent microscopic middle ear surgery took 5 doses of medication, compared to 3 for those who had endoscopic surgery only.

Postoperative pain and medication use in pediatric patients can be effectively measured following middle ear surgery. Continued study with a larger sample size will allow adequate power to resolve whether surgery technique affects postoperative pain.