{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T01:07:28Z","timestamp":1771463248673,"version":"3.50.1"},"reference-count":57,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2020,11,16]],"date-time":"2020-11-16T00:00:00Z","timestamp":1605484800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>Awake, unsedated in\u2010office upper airway procedures are performed frequently and have high completion rates, yet less is known about the patients' pain experience and potentially influencing factors. It is also unclear if patients' pain experiences become worse with repeated procedures. We identified procedure\u2010 and patient\u2010related factors that might influence procedural completion and pain scores.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective chart review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Pre\u2010, intra\u2010, and post\u2010procedure pain scores were collected prospectively for awake unsedated upper airway procedures performed at a single institution over a 5\u2010year period. Patient factors reviewed were demographics, body mass index, psychiatric and\/or pain diagnosis, and related medications. Procedure factors reviewed were procedure type, route, side, and performance of the same procedure multiple times. Patients reported their pain level before, during, and after the procedure using a standard 0 to 10 scale. Maximum pain score change (P\u0394max), or the difference between highest and lowest reported pain levels, was calculated. Descriptive and multivariate analyses were performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Procedure completion was 98.7% for 609 first time patients and 99.0% in 60 patients undergoing 292 repeat procedures. P\u0394max did not covary with age, gender, or BMI. P\u0394max covaried with pain and psychiatric conditions and associated medications. P\u0394max was highest for injection medialization and lowest for tracheoscopy. P\u0394max decreased over time for those undergoing multiple identical procedures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Procedures were performed with a very high completion rate and low pain scores. Age, sex, and BMI did not affect pain experience. A combination of pain and psychiatric conditions did. Injection medialization had the highest P\u0394max and tracheoscopy the lowest.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:italic>Laryngoscope<\/jats:italic>, 131:E1580\u2013E1588, 2021<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.29238","type":"journal-article","created":{"date-parts":[[2020,11,16]],"date-time":"2020-11-16T12:17:54Z","timestamp":1605529074000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Pain Experience and Tolerance of Awake In\u2010Office Upper Airway Procedures: Influencing Factors"],"prefix":"10.1002","volume":"131","author":[{"given":"Chad W.","family":"Whited","sequence":"first","affiliation":[{"name":"Austin Voice Center Austin Ear, Nose, and Throat Clinic  Austin Texas U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Lubin","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Otolaryngology\u2010Head and Neck Surgery University of Wisconsin School of Medicine and Public Health  Madison Wisconsin U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas","family":"Marka","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Otolaryngology\u2010Head and Neck Surgery University of Wisconsin School of Medicine and Public Health  Madison Wisconsin U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ian J.","family":"Koszewski","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Otolaryngology\u2010Head and Neck Surgery University of Wisconsin School of Medicine and Public Health  Madison Wisconsin U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew R.","family":"Hoffman","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Otolaryngology\u2010Head and Neck Surgery University of Wisconsin School of Medicine and Public Health  Madison Wisconsin U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"Schoeff","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Otolaryngology\u2010Head and Neck Surgery University of Wisconsin School of Medicine and Public Health  Madison Wisconsin U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3299-3014","authenticated-orcid":false,"given":"Seth H.","family":"Dailey","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Otolaryngology\u2010Head and Neck Surgery University of Wisconsin School of Medicine and Public Health  Madison Wisconsin U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,11,16]]},"reference":[{"key":"e_1_2_6_2_1","first-page":"241","article-title":"On the subject of the priority in the medication of the larynx and trachea","volume":"1","author":"Green H","year":"1854","journal-title":"Am Med Mon"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348940411300403"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0892-1997(98)80069-6"},{"key":"e_1_2_6_5_1","unstructured":"ZeitelsSM.The History of Laryngeal Imaging|Ento Key. 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