The Post-Operative Pain Experience And An Assessment Of Analgesic Administration In Elective Surgical Patients At A Teaching Hospital In Kingston, Jamaica

anestesia

Postoperative pain continues to be inadequately managed leading to patient discomfort and an increased incidence of a multitude of complications. The objectives of this study were to assess postoperative pain scores, analgesia prescriptions and their implementation and patient satisfaction with their pain control.

A prospective, descriptive cohort study was undertaken at the University Hospital of the West Indies (UHWI), Kingston, Jamaica. Data was collected by trained personnel via a postoperative interview and review of in-patient charts 24 to 48 hours after anaesthesia. A verbal numerical rating scale (VNRS) of 0 to 10 was used to assess pain severity. Data were analysed using SPSS version 12.
A total of 499 patients participated, 290 gynaecological and 209 orthopaedic. There were 368 females (73.7%) and the mean age was 44.7 ± 15.6 years. The majority of patients had general anaesthesia (80.5%). No pain was reported by 10.6% of patients, 20.8% had mild pain (scores of 1-3), 26.3% had moderate pain (4-6), and 42.3% experienced severe pain (7-10). Younger patients (<60 years) and those having undergone orthopaedic procedures reported more severe postoperative pain (p<0.001 and p=0.001 respectively). Opioid analgesics were administered as ordered in only 33.9% of patients and gynaecological patients were less likely to receive opioids at the prescribed dosing intervals (p<0.001). NSAIDs were given as ordered in 80.3% of patients. The majority of patients thought that their pain management was either excellent (43.6%) or very good (25.3%) and only 3.4% assessed their pain control as poor. Gynaecological patients gave better assessments of their pain management (p<0.001).

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