Need for improved treatment of postoperative pain

TY - JOUR

T1 - Need for improved treatment of postoperative pain

AU - Mathiesen, Ole

AU - Thomsen, Berit Ahlmann

AU - Kitter, Birgitte

AU - Dahl, Jørgen Berg

AU - Kehlet, Henrik

PY - 2012

Y1 - 2012

N2 - INTRODUCTION: A cross-sectional study was performed at Rigshospitalet, Copenhagen, a Danish tertiary university hospital, to describe current postoperative pain and nausea treatment with a view to identifying areas with improvement potential. MATERIAL AND METHODS: Data on up to four of the major and most frequent types of surgery were collected from each department based on interviews with the staff, audits of patient courses and electronic patient medication records. Staff guidelines on procedure-specific pain treatment were also collected. RESULTS: Data on 121 patients from 12 surgical departments and 44 procedures were included in the study. No reliable information about the quality of pain management was available as no data on pain scores were detectable for the first three postoperative days (POD) for 55% (day 1), 71% (day 2) and 84% (day 3) of the patients. Most patients (75%) were treated with opioids. Non-opioid analgesic treatment was insufficient as the majority of patients did not receive sufficient 24-hour treatment with paracetamol and non-steroidal anti-inflammatory drugs, and only a minority received combination therapy. Nausea was found in approx. 20% on POD 1-3. Staff pain treatment guidelines were present in 14% of the cases. CONCLUSION: Our results confirm that challenges exist in postoperative pain management as previously observed in multinational surveys. The way forward is procedure-specific treatment plans based on interdisciplinary collaboration implemented in conjunction with organizational changes. This work represents a natural extension of the work of the traditional acute pain clinic.

AB - INTRODUCTION: A cross-sectional study was performed at Rigshospitalet, Copenhagen, a Danish tertiary university hospital, to describe current postoperative pain and nausea treatment with a view to identifying areas with improvement potential. MATERIAL AND METHODS: Data on up to four of the major and most frequent types of surgery were collected from each department based on interviews with the staff, audits of patient courses and electronic patient medication records. Staff guidelines on procedure-specific pain treatment were also collected. RESULTS: Data on 121 patients from 12 surgical departments and 44 procedures were included in the study. No reliable information about the quality of pain management was available as no data on pain scores were detectable for the first three postoperative days (POD) for 55% (day 1), 71% (day 2) and 84% (day 3) of the patients. Most patients (75%) were treated with opioids. Non-opioid analgesic treatment was insufficient as the majority of patients did not receive sufficient 24-hour treatment with paracetamol and non-steroidal anti-inflammatory drugs, and only a minority received combination therapy. Nausea was found in approx. 20% on POD 1-3. Staff pain treatment guidelines were present in 14% of the cases. CONCLUSION: Our results confirm that challenges exist in postoperative pain management as previously observed in multinational surveys. The way forward is procedure-specific treatment plans based on interdisciplinary collaboration implemented in conjunction with organizational changes. This work represents a natural extension of the work of the traditional acute pain clinic.

M3 - Journal article

SN - 2245-1919

VL - 59

SP - A4401

JO - Danish Medical Journal

JF - Danish Medical Journal

IS - 4

ER -