A randomized controlled trial of corticosteroids for pain after transoral robotic surgery

Daniel Clayburgh, Will Stott, Rachel Bolognone, Andrew Palmer, Virginie Achim, Scott Troob, Ryan Li, Daniel Brickman, Donna Graville, Peter Andersen, Neil D. Gross

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Objective: To determine if an extended perioperative course of corticosteroids will improve pain control following transoral robotic surgery (TORS). Study Design: Randomized, double-blind, placebo-controlled trial. Methods: Patients undergoing TORS for initial treatment of oropharyngeal squamous cell carcinoma received a single intraoperative dose of 10-mg dexamethasone and then were randomized to receive 8-mg dexamethasone every 8 hours, or placebo, for up to 4 days after surgery. Pain, measured by visual analog scale (VAS), was the primary outcome measure. Secondary outcome measures included length of stay, dysphagia assessments, and complications. Results: VAS pain scores were similar between steroid and placebo cohorts on postoperative day (POD) 1, 2, and 7 through 21, although they significantly improved in the steroid cohort on POD 3. The steroid cohort also demonstrated a decreased hospital length of stay (median 1 day) and improvement in diet consistency, as measured by the performance status scale on POD 7 through 21. There was no difference in complications between the steroid and placebo cohorts. Conclusion: Extended perioperative corticosteroids after TORS is safe and may allow earlier improvement in diet consistency and decreased length of hospital stay, although postoperative pain appears minimally affected. Level of Evidence: 1b. Laryngoscope, 127:2558–2564, 2017.

Original languageEnglish (US)
Pages (from-to)2558-2564
Number of pages7
JournalLaryngoscope
Volume127
Issue number11
DOIs
StatePublished - Nov 1 2017

Fingerprint

Robotics
Length of Stay
Adrenal Cortex Hormones
Randomized Controlled Trials
Pain
Steroids
Placebos
Pain Measurement
Dexamethasone
Outcome Assessment (Health Care)
Diet
Laryngoscopes
Deglutition Disorders
Postoperative Pain
Ambulatory Surgical Procedures
Squamous Cell Carcinoma

Keywords

  • corticosteroid
  • pain management
  • postoperative care
  • transoral robotic surgery

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

A randomized controlled trial of corticosteroids for pain after transoral robotic surgery. / Clayburgh, Daniel; Stott, Will; Bolognone, Rachel; Palmer, Andrew; Achim, Virginie; Troob, Scott; Li, Ryan; Brickman, Daniel; Graville, Donna; Andersen, Peter; Gross, Neil D.

In: Laryngoscope, Vol. 127, No. 11, 01.11.2017, p. 2558-2564.

Research output: Contribution to journalArticle

Clayburgh, Daniel ; Stott, Will ; Bolognone, Rachel ; Palmer, Andrew ; Achim, Virginie ; Troob, Scott ; Li, Ryan ; Brickman, Daniel ; Graville, Donna ; Andersen, Peter ; Gross, Neil D. / A randomized controlled trial of corticosteroids for pain after transoral robotic surgery. In: Laryngoscope. 2017 ; Vol. 127, No. 11. pp. 2558-2564.
@article{d3a420a5a0554485b0325c970366a515,
title = "A randomized controlled trial of corticosteroids for pain after transoral robotic surgery",
abstract = "Objective: To determine if an extended perioperative course of corticosteroids will improve pain control following transoral robotic surgery (TORS). Study Design: Randomized, double-blind, placebo-controlled trial. Methods: Patients undergoing TORS for initial treatment of oropharyngeal squamous cell carcinoma received a single intraoperative dose of 10-mg dexamethasone and then were randomized to receive 8-mg dexamethasone every 8 hours, or placebo, for up to 4 days after surgery. Pain, measured by visual analog scale (VAS), was the primary outcome measure. Secondary outcome measures included length of stay, dysphagia assessments, and complications. Results: VAS pain scores were similar between steroid and placebo cohorts on postoperative day (POD) 1, 2, and 7 through 21, although they significantly improved in the steroid cohort on POD 3. The steroid cohort also demonstrated a decreased hospital length of stay (median 1 day) and improvement in diet consistency, as measured by the performance status scale on POD 7 through 21. There was no difference in complications between the steroid and placebo cohorts. Conclusion: Extended perioperative corticosteroids after TORS is safe and may allow earlier improvement in diet consistency and decreased length of hospital stay, although postoperative pain appears minimally affected. Level of Evidence: 1b. Laryngoscope, 127:2558–2564, 2017.",
keywords = "corticosteroid, pain management, postoperative care, transoral robotic surgery",
author = "Daniel Clayburgh and Will Stott and Rachel Bolognone and Andrew Palmer and Virginie Achim and Scott Troob and Ryan Li and Daniel Brickman and Donna Graville and Peter Andersen and Gross, {Neil D.}",
year = "2017",
month = "11",
day = "1",
doi = "10.1002/lary.26625",
language = "English (US)",
volume = "127",
pages = "2558--2564",
journal = "Laryngoscope",
issn = "0023-852X",
publisher = "John Wiley and Sons Inc.",
number = "11",

}

TY - JOUR

T1 - A randomized controlled trial of corticosteroids for pain after transoral robotic surgery

AU - Clayburgh, Daniel

AU - Stott, Will

AU - Bolognone, Rachel

AU - Palmer, Andrew

AU - Achim, Virginie

AU - Troob, Scott

AU - Li, Ryan

AU - Brickman, Daniel

AU - Graville, Donna

AU - Andersen, Peter

AU - Gross, Neil D.

PY - 2017/11/1

Y1 - 2017/11/1

N2 - Objective: To determine if an extended perioperative course of corticosteroids will improve pain control following transoral robotic surgery (TORS). Study Design: Randomized, double-blind, placebo-controlled trial. Methods: Patients undergoing TORS for initial treatment of oropharyngeal squamous cell carcinoma received a single intraoperative dose of 10-mg dexamethasone and then were randomized to receive 8-mg dexamethasone every 8 hours, or placebo, for up to 4 days after surgery. Pain, measured by visual analog scale (VAS), was the primary outcome measure. Secondary outcome measures included length of stay, dysphagia assessments, and complications. Results: VAS pain scores were similar between steroid and placebo cohorts on postoperative day (POD) 1, 2, and 7 through 21, although they significantly improved in the steroid cohort on POD 3. The steroid cohort also demonstrated a decreased hospital length of stay (median 1 day) and improvement in diet consistency, as measured by the performance status scale on POD 7 through 21. There was no difference in complications between the steroid and placebo cohorts. Conclusion: Extended perioperative corticosteroids after TORS is safe and may allow earlier improvement in diet consistency and decreased length of hospital stay, although postoperative pain appears minimally affected. Level of Evidence: 1b. Laryngoscope, 127:2558–2564, 2017.

AB - Objective: To determine if an extended perioperative course of corticosteroids will improve pain control following transoral robotic surgery (TORS). Study Design: Randomized, double-blind, placebo-controlled trial. Methods: Patients undergoing TORS for initial treatment of oropharyngeal squamous cell carcinoma received a single intraoperative dose of 10-mg dexamethasone and then were randomized to receive 8-mg dexamethasone every 8 hours, or placebo, for up to 4 days after surgery. Pain, measured by visual analog scale (VAS), was the primary outcome measure. Secondary outcome measures included length of stay, dysphagia assessments, and complications. Results: VAS pain scores were similar between steroid and placebo cohorts on postoperative day (POD) 1, 2, and 7 through 21, although they significantly improved in the steroid cohort on POD 3. The steroid cohort also demonstrated a decreased hospital length of stay (median 1 day) and improvement in diet consistency, as measured by the performance status scale on POD 7 through 21. There was no difference in complications between the steroid and placebo cohorts. Conclusion: Extended perioperative corticosteroids after TORS is safe and may allow earlier improvement in diet consistency and decreased length of hospital stay, although postoperative pain appears minimally affected. Level of Evidence: 1b. Laryngoscope, 127:2558–2564, 2017.

KW - corticosteroid

KW - pain management

KW - postoperative care

KW - transoral robotic surgery

UR - http://www.scopus.com/inward/record.url?scp=85031911799&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85031911799&partnerID=8YFLogxK

U2 - 10.1002/lary.26625

DO - 10.1002/lary.26625

M3 - Article

VL - 127

SP - 2558

EP - 2564

JO - Laryngoscope

JF - Laryngoscope

SN - 0023-852X

IS - 11

ER -