Multicenter study on effectiveness of controlling postoperative pain in Colombian patients
Introduction: Postoperative pain can cause complications, prolonged hospital stays and has often been poorly assessed.
Objectives: To determine the intensity of pain in patients operated on using a visual analog scale (VAS) and to identify variables associated with a lack of control in seven cities in Colombia.
Materials and methods: Cross-sectional study in patients older than 18 years between 1st January and 30th September, 2014 in eight clinics across Colombia. The intensity of postoperative pain was assessed with a VAS 4h after the procedure. Socio-demographic, clinical and pharmacological variables were considered. Multivariate analysis was done using SPSS 22.0.
Results: A total of 1015 patients were evaluated. The mean age was 42.5 ± 17.1 years, and 63.8% were female. The mean pain level was 38.8 ± 19.4 mm, with a total of 600 (59.1% of patients) without pain control. Dipyrone was the most used analgesic, followed by morphine and tramadol. Being treated at Nuestra Señora del Rosario Clinic in Ibagué (OR: 1.65; 95%CI: 1.096-2.479; p = 0.016), coming from urban areas (OR: 1.71; 95%CI: 1.186-2.463; p = 0.005), being subjected to major surgery (OR: 2.02; 95%CI: 1.316-3.109; p = 0.001), emergency surgery (OR: 1.46; 95%CI: 1.065-2.013; p = 0.019), and suffering nausea (OR: 2.05; 95%CI: 1.341-3.118; p = 0.001) were statistically associated with no pain control.
Conclusion: None of the clinics had acceptable percentages of patients with pain controlled 4 h after surgery. Clinical practice guides should be incorporated, institutional policies should be defined, health personnel should be trained, and the outcomes of the interventions should be evaluated.
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