Survey of postoperative pain control in different types of hospitals: a multicenter observational study

BMC Anesthesiology

Piotr Gałkin¹  Michał Domagała²  Agata Hanych³  Dariusz Onichimowski⁴  Klaudia Zyzak⁵  Mirosław Czuczwar⁵  Michał Borys⁵  Justyna Miękina⁵  Katarzyna Gałaszkiewicz⁵  Agata Kłaput⁵  Kai Wróblewski⁵ 

[1] The Department of Anaesthesia and Intensive Therapy, Jedrzej Sniadecki Hospital;The Department of Anaesthesia and Intensive Therapy, Saint Lukash Hospital;The Department of Anaesthesia and Intensive Therapy, The Podkarpackie Center of Lung Disease;The Department of Anaesthesia and Intensive Therapy, University of Warmia and Mazury;The Second Department of Anaesthesiology and Intensive Therapy, Medical University of Lublin;

关键词: Postoperative pain management;    Analgesia;    Analgesics;    Multimodal analgesia;   

DOI  :  10.1186/s12871-018-0551-3

来源: DOAJ

【 摘 要 】

Abstract Background Current pain assessment and treatment does not address every patient’s requirements. Although the Polish national guidelines for post-operative pain management have been published, many patients experience severe pain in the postoperative period. The main goal of our study was to assess pain severity among patients from different types of hospitals (primary, secondary, and tertiary centers) after similar types of surgeries. We also aimed to determine if there were any differences in pain severity associated with anesthesia technique, type of surgery, and the patient’s age and sex. Methods This was a prospective, observational study. A questionnaire form was used to collect demographic data, type of hospital, surgery, anesthesia, and patient satisfaction of pain control in the postoperative period. The visual analogue scale (VAS) was used to measure pain severity at four time points after surgery (4, 8, 12, and 24 h). Results The study was conducted from November 2015 to June 2016 in seven hospitals in Eastern Poland, and 269 women and 293 men participated. At the 4-h measurement, 39.32% of patients assessed the pain as moderate and 19.75% as severe. A difference was found in pain intensity between patients treated in primary and secondary hospitals. Vascular surgery patients had the lowest pain intensity (19 (13–26)), especially in comparison to those undergoing thoracic surgery (30 (27–33)). A sudden elevation in pain severity among patients anesthetized with single-shot spinal technique was observed. Only 4.9% of participants received strong opioids during the first 24 h after surgery. Conclusions Postoperative pain control seems to be unexpectedly poor after single-shot subarachnoid anesthesia. Despite concerns, the use of analgesics may be insufficient in some groups of patients. Our study indicates new variables that influence the severity of pain, such as operated region, anesthetic technique, and type of surgical department. The results obtained in our study are in discrepancy with recommendations presented by the national guidelines for post-operative pain management.

【 授权许可】

Unknown