Postoperative Pain Course After Uvulopalatoplasty

Characterization of the Postoperative Pain Course and Intensity After Uvulopalatoplasty With Radiofrequency Knife (RAUP)

The aim of this study is to determine the postoperative course including effects on the quality of life following soft palate surgery with radiofrequency knife (RAUP).

Study Overview

• Status: Completed
• Conditions: Quality of Life; Pain, Postoperative; Snoring; Surgical Procedures, Operative

Detailed Description

For the treatment of social snoring one common treatment modality is the surgical reconstruction of the soft palate. The procedure is a routine operation performed at nearly all Ear-Nose- and Throat departments in Norway. The surgery is done with local anaesthesia in an out-patient setting where the patients' postoperative observation at the hospital is limited to 1-2 hours. As the surgery is done in the sensitive mucosa and palatopharyngeal musculature the postoperative course might be unpleasant. The patients are therefore in the need of regular postoperative pain treatment extending into the 2 first weeks after surgery.

At hospitals the uvulopalatoplasty is performed using a radiofrequency knife (RAUP) after the soft palate has been infiltrated with local anaesthesia (1% xylocain/adrenaline). The incision is done paramedialy to the uvular base and up into the musculature of the soft palate then making a smooth arch toward the pharyngeal tonsil upper limit. The then elongated uvula is amputated to about ½ cm. Occasionally, a suture is placed laterally and medially to lift the palate and prevent postoperative scaring. Coagulation is done if necessary with light bipolar diathermy.

As the postoperative course might be unpleasant after RAUP it is of interest to study the time course and intensity of pain after surgery when using the standardised postoperative pain treatment at OmniaSykehuset. The result will be useful in future studies looking at ways to improve the pain treatment after uvulopalatoplasty.

• Study Type: Observational
• Enrollment (Actual): 33

Contacts and Locations

Study Locations

• Norway
  • Oslo, Norway, NO-0264
    • Aleris Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 14 years to 76 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Patients of either sex, of Caucasian origin, between the age of 18 and 80, who are referred to the hospital for snoring that have been subjected to a sleep study indicating that uvulopalatoplasty might have a considerable affect on the snoring.

Description

Inclusion Criteria:

• Patients of either sex of Caucasian origin who are referred to the hospital for snoring that have been subjected to a sleep study indicating that uvulopalatoplasty might have a considerable affect on the snoring.

Exclusion Criteria:

• Chronic drug treatment (except birth control medication) with analgesics, anti-inflammatory treatment (both steroidal (SAIDs) and non-steroidal anti-inflammatory drugs (NSAIDs)) apart from standard postoperative analgesic treatment administered by the operator.
• Patients with diabetes.
• Patients who due to age or communication skills are considered unable to complete patient forms.
• Professional evaluation suggests an alteration of the planned surgical area or treatment form.
• Known or assumed intolerance or hyper sensibility to diclofenac, codeine or paracetamol (standard postoperative analgesic treatment).
• Consumption of alcohol in the period from 2 days before or until the end of the primary observation period (postoperative days 0-7

Study Plan

How is the study designed?

Design Details

• Observational Models: Cohort
• Time Perspectives: Prospective

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort
RAUP treatment; Patients referred to the hospital for a snoring problem

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Pain Intensity 0-10 Numerical Rating Scale	14 days

Secondary Outcome Measures

Outcome Measure	Time Frame
Norwegian McGill Pain Questionnaire (NMPQ)	14
Norwegian Translated Short-Form McGill Pain Questionnaire (NTSF-MPQ)	14 days
Oral Health Impact Profile (OHIP-14)	14 days
Corahs Dental Anxiety Scale (CDAS)	1 day

Collaborators and Investigators

• Sponsor: Ullevaal University Hospital
• Collaborators: University of Oslo
• Investigators: Principal Investigator: Øystein S Eskeland, MD, University of Oslo; Study Chair: Lasse A Skoglund, DDS, DSci, University of Oslo; Study Director: Per Skjelbred, MD, DDS, Ullevaal University Hospital

Publications and helpful links

General Publications

• Corah NL. Dental anxiety. Assessment, reduction and increasing patient satisfaction. Dent Clin North Am. 1988 Oct;32(4):779-90.
• Kim HS, Schwartz-Barcott D, Holter IM, Lorensen M. Developing a translation of the McGill pain questionnaire for cross-cultural comparison: an example from Norway. J Adv Nurs. 1995 Mar;21(3):421-6. doi: 10.1111/j.1365-2648.1995.tb02722.x.
• Melzack R. The short-form McGill Pain Questionnaire. Pain. 1987 Aug;30(2):191-197. doi: 10.1016/0304-3959(87)91074-8.
• Melzack R. The McGill Pain Questionnaire: major properties and scoring methods. Pain. 1975 Sep;1(3):277-299. doi: 10.1016/0304-3959(75)90044-5.
• Slade GD. Derivation and validation of a short-form oral health impact profile. Community Dent Oral Epidemiol. 1997 Aug;25(4):284-90. doi: 10.1111/j.1600-0528.1997.tb00941.x.

Study record dates

Study Major Dates

• Study Start: June 1, 2005
• Primary Completion (Actual): May 1, 2008
• Study Completion (Actual): June 1, 2008

Study Registration Dates

• First Submitted: June 9, 2009
• First Submitted That Met QC Criteria: June 10, 2009
• First Posted (Estimate): June 11, 2009

Study Record Updates

• Last Update Posted (Estimate): July 6, 2011
• Last Update Submitted That Met QC Criteria: July 3, 2011
• Last Verified: June 1, 2005

More Information

Terms related to this study

• Keywords: quality of life; postoperative pain; uvulopalatoplasty
• Additional Relevant MeSH Terms: Pathologic Processes; Postoperative Complications; Pain; Neurologic Manifestations; Signs and Symptoms, Respiratory; Respiratory Sounds; Pain, Postoperative; Snoring
• Other Study ID Numbers: OES-002