Author Participant Information:
(Patient numbers, Average age (years), Male:Female, Other)
Dropout rate
(Active group vs Comparison group)
Method of pain measurement Results
Castro et al. 2003 [38] 62 active, 24 placebo
63 (33 - 87) vs. 61 (40 - 82)
50:12 vs. 17:7
1.6% (1/63) vs 0 Treatment goals questionnaire;
Quality of life (FACT, HN and KPS)
37% (23/62) patients in active group experienced patient benefit, 34% of which was pain control.
12% (3/24) in the placebo group experienced patient benefit; P = 0.25
Georgiou et al. 2000 [39] 16 thoracic epidural, 13 cervical epidural
68 vs. 69
15:1 vs. 13:0
0 VAS Cervical epidural morphine decreased pain based on VAS on days 1, 2, 5 and 10. Duration of analgesia for cervical epidural approximately 4 hours longer than thoracic epidural (P < 0.5). Cervical epidural required small doses
Jovic et al. 2008 [40] 30 Ketoprofen, 30 Metamizole
60.2 (43 - 79) vs. 54.8 (32 - 72)
25:5 vs. 27:3
0 VNS Both medications effective. Analgesia better with Ketoprofen but not significant over the first 2 days. On day 3 the rating score was significantly lower for patients on Ketoprofen than Metamizole (P < 0.05)
McNeely et al. 2004 [47] 10 exercise group
10 control group
60 vs. 61
7:1, 7:2
20% (2/10) vs; 10% (1/10) SPADI PRET has a beneficial effect on pain. Overall pain score decreased in active group by 17% compared to a slight increase (1.7%) in control group.
McNeely et al. 2008 [27] 27 PRET group, 25 TP group
57 (43 - 76) vs. 53 (32 - 76)
20:7 vs. 17:8
7.4% (2/27) vs 12% (3/25) SPADI PRET group experienced decreased SPADI scores from baseline of 19.6 to 7.6 and a mean change of -11.8 compared to TP with a mean change of -7,4.
Pfister et al. 2010 [48] 28 active, 30 placebo
61 vs. 57
15:13 vs. 23:7
17.7% (6/34) vs 11.1% (4/36) Composite score of pain, function, and activities of daily living provided by the Constant-Murley instrument Acupuncture was superior to control for all outcome measures. Acupuncture patients scored 11.2 points higher than controls on the Constant-Murley scale (95% CI, 3.0 to 19.3; P = 0.008).
Plantevin et al. 2007 [41] 21 MNB group, 21 placebo group
55 (40 - 70) vs. 52 (37 - 76)
18:1 vs 19:1
9.5% (2/21) vs 4.8% (1/21) VAS, morphine consumption Morphine consumption at 24 h: MNB group 26.7 (18) mg vs. control group 48.5 (26.3) mg; Morphine consumption over each 2 h time interval was lower in MNB group for the first 12 hours; No difference at 48h
Roussier et al. 2006 [42] 22 in PCA-IV route, 20 in PCA-Epidural route
58 (44 - 81) vs. 57 (33 - 71)
20:2 vs 19:1
All smokers with chronic bronchitis
4.8% (1/21) vs 12% (3/25) VAS, Fentanyl consumption and number of PCA demands. VAS pain scores at rest in the Epidural group were 1.75 (3.25) and 1.75 (3) vs 5.5 (5.25) and 3.25 (3) in the IV group, 2 and 6 h after surgery respectively. Cumulative Fentanyl consumption: Epidural group: 1412 mg (912), IV group: 1287 mg (1200); Cumulative number of demands: Epidural group: 68 (76), IV group: 75 (122)
Saxena et al. 1994 [43] 25 in Piroxicam, 25 ASA
56.2 (30 - 79) vs. 59.9 (31 - 79)
23:2 vs. 22:3
20% (5/25) vs 36% (9/25) Review questionnaire including pain NRS NRS (SD) initially was 7.05 (1.97) in Piroxicam group and 5.8 (1.96) in ASA group. Mean pain score (SD) in Piroxicam group was 5.2 (2.73) and in ASA group was 3.31 (1.56) after 4 days of treatment.
Singhal et al. 2006 [44] 30 active, 30 placebo
50.30 (37.4 - 62.9) vs. 48.60 (37.60 - 59.60)
21:9 vs. 27:3
0 VAS Epidural morphine provided better analgesia than IV morphine (P < 0.05)
Werner et al. 2002 [45] 57 active, 35 placebo
60 (37 - 82) vs 62 (43 - 84)
45:12 vs 30:5
More primary tumours in active group, more metastatic in placebo
56.1% (32/57) vs 82.9% (29/35) Treatment Goals Questionnaire; Quality of life (FACT, HN) 19% (11/57) patients in active group achieved patient benefit including pain control 9% (3/35) patients in placebo group achieved patient benefit; P = 0.24
Wittekindt et al. 2006 [46] 13 low dose group, 10 high dose group
21:2
0 VAS 56.5% (13/23) experienced pain relief with 69.2% (9/13) experiencing pain relief in the low dose group compared to 40% (4/10) for the high dose group. No statistically significant decrease in VAS score at baseline and 28 days (P = 0.15)
Yagi et al. 1997 [35] 10 IV Fentanyl group, 10 Piroxicam,
10 control group
No information VAS, Verbal Pain score (0 - 3), face scale Continuous intravenous infusion of a small dose of Fentanyl or periodical administration of Piroxicam prior to surgery produced better postoperative analgesia after head and neck surgery in comparison to the control group.

MNB = mandibular nerve block; VAS = Visual Analogue Scale; PCA = patient controlled analgesia; SPADI = Shoulder Pain and Disability Index; PRET = progressive resistance exercise training; TP = exercise protocol; VNS = Visual Numerical Scale; NRS = Numerical Rating Scale; ASA = acetylsalicylic acid; HN = head and neck; FACT= Functional Assessment of Cancer Therapy Head and Neck ; KPS = Karnofsky Performance Status.