Suzetrigine for Postoperative Pain in Head and Neck Free Flap or Transoral Robotic Surgery
Abstract
Importance
Postoperative pain after head and neck surgery frequently necessitates opioid analgesia despite multimodal pain regimens. Suzetrigine, a selective NaV1.8 inhibitor that was recently approved in the US for acute postoperative pain, may reduce postoperative opioid requirements. However, the current surgical literature regarding suzetrigine use after head and neck surgery is limited.
Objective
To evaluate the association of adjunctive suzetrigine use with postoperative opioid consumption after head and neck free flap reconstruction and transoral robotic surgery.
Design, Setting, and Participants
This was a retrospective cohort study conducted at a single tertiary academic referral center of adult patients undergoing head and neck free flap reconstruction or transoral robotic surgery from January 1 to December 31, 2025. Patients with chronic high-dose opioid use, chronic pain disorders, liver dysfunction, or unavailable opioid data were excluded.
Exposure
Protocolized multimodal analgesic regimen with or without adjunctive suzetrigine.
Main Outcomes and Measures
Total inpatient morphine milligram equivalents (MMEs) consumed and MME consumption per hospital day. Secondary outcomes included hospital length of stay, 30-day readmissions, emergency department visits, oral intake consumption, postoperative pain scores, and medication-related adverse events.
Results
Of 146 patients (mean [SD] age, 62.8 [13.9] years; 48 female [32.9%] and 98 male [67.1%]) included in the…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 146 participants or records.
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