Outcomes of Pain Management after Thyroidectomy for ENT Patients in the Post-anesthesia Care Unit

Abstract

Background and objectives: A thyroidectomy is considered a surgical procedure with low to moderate risk. However, acute post-operative pain remains a significant clinical issue. The objective of this study were to evaluate postoperative pain management outcomes following thyroidectomy in the PACU and to identify factors associated with postoperative pain.

Methods: This retrospective descriptive study examined 136 patients, who had undergone thyroidectomies under general anesthesia at the Department of Otolaryngology at Srinagarind Hospital between January–December 2024. The demographic data, the surgical and anesthetic details, the pain scores using the numeric rating scale (NRS), the analgesic management, and the post-operative complications were collected from the medical records.

Results: Most patients were female (90.44%) with a mean age of 52.20 years, who were ASA class II (67.65%) and who had undergone thyroid lobectomy (58.82%). Moderate to severe pain levels (NRS≥4) had been reported in 47.79% of patients upon PACU admission. However, before discharge, that number had decreased to 18.38%. The minimum time for the first analgesic administration by the nurse anesthetist was 5 minutes. No factor was found to be significantly associated with NRS≥4 (p>0.05), although a trend toward higher pain levels was observed in patients with ASA class III, (Adjusted Odds Ratio (AOR) = 3.72, 95% CI: 0.93-14.81, p=0.062)and with surgical durations >120 minutes (AOR = 3.72, 95% CI: 0.95-14.51, p=0.059).

Conclusion: Post-operative pain management in the PACU was effective in reducing pain levels in thyroidectomy patients. Close monitoring and individualized pain assessment should be emphasized, particularly in high-risk patients such as those with prolonged surgical time (>2 hours) and ASA class III status, to ensure optimal post-operative recovery.