Analgesia requirements
We found increased requirement for analgesia in the microscopic group at
day 1 post-operatively, and an increased requirement for opioid
analgesia at day 1 and day 2 post-operatively in the microscopic group
(Table 3; Table 4). Kakehata et al. kept patients as inpatients
for the course of their stay, and only offered hospital prescribed
NSAIDs.4 They detected significantly lower analgesia
use post-operatively in their endoscopic compared to microscopic group
from day 1 to day 7. Although Salman et al. also found a trend
towards lower painkiller use in patients who were operated
endoscopically, these results did not reach
significance.5 Baazil et al. reported that the
endaural microscopic group required half as much medication as their
retro-auricular microscopic and endaural transmeatal groups, a result
which is unexplained.6 However, their endoscopic group
had a lower requirement for opioids for pain control post-operatively
compared to the other groups, consistent with our findings. We therefore
believe that the current evidence points towards lesser analgesia
requirements after EES.