Are we controlling postoperative pain?
Keywords:
Pain, Postoperative, Analgesics, Opioid, Pain Analgesia
Abstract
Introduction: Immediate postoperative pain has been underestimated and managed inadequately.
Objectives: To assess perceived pain 4 h after surgery in patients at the San Jorge University Hospital in the city of Pereira.
Materials and methods: Cross-sectional study in patients over 18 years of age was conducted between September 2nd and October 28th, 2011. Postoperative pain intensity was assessed using the Visual Analog Scale, 4h after completing the procedure. Social, demographic, clinical and pharmacological variables were considered. The analysis was done using the SPSS 20.0 for Windows.
Results: Of the 213 postoperative patients studied, 114 (53.6%) were women and 99 (46.4%) were men, with a mean age of 47.1 ± 20.0 years. At 4h, 51.4% of patients did not have pain control. There was a statistically significant association between lack of control and age, living in the urban area, type of surgery, non-adherence to the dose, and monotherapy analgesia.
Discussion: Inadequate pain control requires revisiting its management, ideally on the basis of clinical practice guidelines and using analgesic drugs at adequate doses and intervals.
References
1. International Association for the Study of Pain [sede web]. Seattle: Merskey H, Bogduk N; 1994. IASP taxonomy [accessed on 16.02.12]. Available at: http://www.iasp-pain.org/Content/ NavigationMenu/GeneralResourceLinks/PainDefinitions/ default.htm
2. Carr DB, Goudas LC. Acute pain. Lancet. 1999;353:2051-8.
3. Dolin SJ, Cashman JN, Bland JM. Effectiveness of acute postoperative pain management. I. Evidence from published data. Br J Anaesth. 2002;89:409-23.
4. Muñoz-Blanco F, Salmerón J, Santiago J, Marcote C. Complicaciones del dolor postoperatorio. Rev Soc Esp Dolor. 2001;8:194-211.
5. Martinez-Vazquez de Castro J, Torres LM. Prevalencia del dolor postoperatorio. Alteraciones Fisiopatologicas y sus repercusiones. Rev Soc Esp Dolor. 2000;7:465-76.
6. Finkel DM, Schlegel HR. El dolor postoperatorio. Conceptos básicos y fundamentos para un tratamiento adecuado. Rev Hosp Gen Agudos Dr J M Ramos Mejía. 2003;8:1-17.
7. Reyes Fierro A, de la Gala García F. Dolor postoperatorio: analgesia multimodal. Patología del Aparato Locomotor. 2004;2:176-88.
8. Brandsborg B. Pain following hysterectomy: epidemiological and clinical aspects. Dan Med J. 2012;59:B4374.
9. Campbell J. Pain: the fifth vital sign. In: Presidential address presented at the meeting of the American Pain Society. 1995.
10. Gkotsi A, Petsas D, Sakalis V, Fotas A, Triantafyllidis A, Vouros I, et al. Pain point system scale (PPSS): a method for postoperative pain estimation in retrospective studies. J Pain Res. 2012;5:503-10.
11. Craine M, Kerns RD. Pain management improvement strategies in the Veteran's Health Administration. APS Bull. 2003. Available at: http://www.ampainsoc.org/pub/bulletin/ sep03/article1.htm [accessed on 16.02.12]
12. Veterans Health Administration. Pain as the 5th vital sign toolkit. October 2000, revised edition. Geriatrics and Extended Care Strategic Healthcare Group, National Pain Management Coordinating Committee; 2005. Available at: http://www.va. gov/oaa/pocketcard/pain.asp [accessed on 16.02.12]
13. Kehlet H. Multimodal approach to control postoperative pathophysiology and rehabilitation. Br J Anaesth. 1997;78:606-17.
14. American Society of Anesthesiologists Task Force on Acute Pain Management. Practice guidelines for acute pain management in the perioperative setting: an updated report by the American Society of Anesthesiologists Task Force on Acute Pain Management. Anesthesiology. 2004;100:1573-81.
15. DeLoach LJ, Higgins MS, Caplan AB, Stiff JL. The visual analog scale in the immediate postoperative period: intrasubject variability and correlation with a numeric scale. Anesth Analg. 1998;86:102-6.
16. Dexter F, Chestnut DH. Analysis of statistical tests to compare visual analog scale measurements among groups. Anesthesiology. 1995;82:896-902.
17. Myles PS, Troedel S, Boquest M, Reeves M. The pain visual analog scale: is it linear or nonlinear? Anesth Analg. 1999;89:1517-20.
18. Robaina F. ¿Por qué las Unidades del Dolor deben ser multidisciplinarias? Rev Soc Esp Dolor. 2005;12:137-40.
19. Cardona E, Castaño M, Builes A, Castro G. Manejo del dolor postquirórgico en el Hospital Universitario San Vicente de Paul de Medellín. Rev Col Anest. 2003;31:111-6.
20. López S, Méndez H, Real J, Gordo F, Fernández DL. Manejo de la analgesia postoperatoria en las primeras 24 horas en un Hospital de segundo nivel. Rev Soc Esp Dolor. 2006;13:18-23.
21. Gallego JI, Rodriguez de la Torre MR, Vazquez-Guerrero JC, Gil M. Estimation of the prevalence and severity of postoperative pain and relation with patient satisfaction. Rev Soc Esp Dolor. 2004;11:197-202.
22. Cadavid A, Mendoza J, Gómez N, Berrío M. Prevalencia de dolor agudo posoperatorio y calidad de la recuperación en el Hospital Universitario San Vicente de Paól, Medellín, Colombia, 2007. IATREIA. 2009;22:11-5.
23. Machado-Alba J, Quintero A, Mena M, Castaño C, Lopez E, Marin D, et al. Evaluación del manejo del dolor postquirórgico en pacientes adultos de una clínica de tercer nivel de Pereira, Colombia. Rev Investigaciones Andina. 2012;14:547-59.
24. Allegri M, Clark MR, De Andrés J, Jensen TS. Acute and chronic pain: where we are and where we have to go. Minerva Anestesiol. 2012;78:222-35.
25. Rocchi A, Chung F, Forte L. Canadian survey of postsurgical pain and pain medication experiences. Can J Anaesth. 2002;49:1053-6.
26. Usichenko TI, Röttenbacher I, Kohlmann T, Jülich A, Lange J, Mustea A, et al. Implementation of the quality management system improves postoperative pain treatment: a prospective pre-/post-interventional questionnaire study. Br J Anaesth. 2013;110:87-95.
27. Moreno-Azcoitia M, De Andrés J, Torres L, Vidal M. Estudio Observacional sobre el dolor postoperatorio leve o moderado desde el punto de vista del anestesiólogo en España. PATHOS. Rev Soc Esp Dolor. 2007;14:550-67.
28. Morrison RS, Magaziner J, Gilbert M, Koval KJ, McLaughlin MA, Orosz G, et al. Relationship between pain and opioid analgesics on the development of delirium following hip fracture. J Gerontol A Biol Sci Med Sci. 2003;58:76-81.
29. Valentín López B, García Caballero J, Muííoz Ramón JM, Aparicio Grande P, Díez Sebastán J, Criado Jiménez A. Postoperative pain management in a tertiary care hospital: initial situation prior to starting a quality assurance program. Rev Esp Anestesiol Reanim. 2006;53:408-18.
30. Brennan F, Cousins MJ. Pain relief as a human right. Rev Soc Esp Dolor. 2005;12:17-23.
31. Soler E, Faus MT, Montaner MC, Morales F, Martínez-Pons V. Prevalencia, tratamiento y factores determinantes del dolor postoperatorio en un servicio de cirugía general y aparato digestivo. Rev Soc Esp Dolor. 2001;8:317-26.
32. Manion SC, Brennan TJ. Thoracic epidural analgesia and acute pain management. Anesthesiology. 2011;115:181-8.
2. Carr DB, Goudas LC. Acute pain. Lancet. 1999;353:2051-8.
3. Dolin SJ, Cashman JN, Bland JM. Effectiveness of acute postoperative pain management. I. Evidence from published data. Br J Anaesth. 2002;89:409-23.
4. Muñoz-Blanco F, Salmerón J, Santiago J, Marcote C. Complicaciones del dolor postoperatorio. Rev Soc Esp Dolor. 2001;8:194-211.
5. Martinez-Vazquez de Castro J, Torres LM. Prevalencia del dolor postoperatorio. Alteraciones Fisiopatologicas y sus repercusiones. Rev Soc Esp Dolor. 2000;7:465-76.
6. Finkel DM, Schlegel HR. El dolor postoperatorio. Conceptos básicos y fundamentos para un tratamiento adecuado. Rev Hosp Gen Agudos Dr J M Ramos Mejía. 2003;8:1-17.
7. Reyes Fierro A, de la Gala García F. Dolor postoperatorio: analgesia multimodal. Patología del Aparato Locomotor. 2004;2:176-88.
8. Brandsborg B. Pain following hysterectomy: epidemiological and clinical aspects. Dan Med J. 2012;59:B4374.
9. Campbell J. Pain: the fifth vital sign. In: Presidential address presented at the meeting of the American Pain Society. 1995.
10. Gkotsi A, Petsas D, Sakalis V, Fotas A, Triantafyllidis A, Vouros I, et al. Pain point system scale (PPSS): a method for postoperative pain estimation in retrospective studies. J Pain Res. 2012;5:503-10.
11. Craine M, Kerns RD. Pain management improvement strategies in the Veteran's Health Administration. APS Bull. 2003. Available at: http://www.ampainsoc.org/pub/bulletin/ sep03/article1.htm [accessed on 16.02.12]
12. Veterans Health Administration. Pain as the 5th vital sign toolkit. October 2000, revised edition. Geriatrics and Extended Care Strategic Healthcare Group, National Pain Management Coordinating Committee; 2005. Available at: http://www.va. gov/oaa/pocketcard/pain.asp [accessed on 16.02.12]
13. Kehlet H. Multimodal approach to control postoperative pathophysiology and rehabilitation. Br J Anaesth. 1997;78:606-17.
14. American Society of Anesthesiologists Task Force on Acute Pain Management. Practice guidelines for acute pain management in the perioperative setting: an updated report by the American Society of Anesthesiologists Task Force on Acute Pain Management. Anesthesiology. 2004;100:1573-81.
15. DeLoach LJ, Higgins MS, Caplan AB, Stiff JL. The visual analog scale in the immediate postoperative period: intrasubject variability and correlation with a numeric scale. Anesth Analg. 1998;86:102-6.
16. Dexter F, Chestnut DH. Analysis of statistical tests to compare visual analog scale measurements among groups. Anesthesiology. 1995;82:896-902.
17. Myles PS, Troedel S, Boquest M, Reeves M. The pain visual analog scale: is it linear or nonlinear? Anesth Analg. 1999;89:1517-20.
18. Robaina F. ¿Por qué las Unidades del Dolor deben ser multidisciplinarias? Rev Soc Esp Dolor. 2005;12:137-40.
19. Cardona E, Castaño M, Builes A, Castro G. Manejo del dolor postquirórgico en el Hospital Universitario San Vicente de Paul de Medellín. Rev Col Anest. 2003;31:111-6.
20. López S, Méndez H, Real J, Gordo F, Fernández DL. Manejo de la analgesia postoperatoria en las primeras 24 horas en un Hospital de segundo nivel. Rev Soc Esp Dolor. 2006;13:18-23.
21. Gallego JI, Rodriguez de la Torre MR, Vazquez-Guerrero JC, Gil M. Estimation of the prevalence and severity of postoperative pain and relation with patient satisfaction. Rev Soc Esp Dolor. 2004;11:197-202.
22. Cadavid A, Mendoza J, Gómez N, Berrío M. Prevalencia de dolor agudo posoperatorio y calidad de la recuperación en el Hospital Universitario San Vicente de Paól, Medellín, Colombia, 2007. IATREIA. 2009;22:11-5.
23. Machado-Alba J, Quintero A, Mena M, Castaño C, Lopez E, Marin D, et al. Evaluación del manejo del dolor postquirórgico en pacientes adultos de una clínica de tercer nivel de Pereira, Colombia. Rev Investigaciones Andina. 2012;14:547-59.
24. Allegri M, Clark MR, De Andrés J, Jensen TS. Acute and chronic pain: where we are and where we have to go. Minerva Anestesiol. 2012;78:222-35.
25. Rocchi A, Chung F, Forte L. Canadian survey of postsurgical pain and pain medication experiences. Can J Anaesth. 2002;49:1053-6.
26. Usichenko TI, Röttenbacher I, Kohlmann T, Jülich A, Lange J, Mustea A, et al. Implementation of the quality management system improves postoperative pain treatment: a prospective pre-/post-interventional questionnaire study. Br J Anaesth. 2013;110:87-95.
27. Moreno-Azcoitia M, De Andrés J, Torres L, Vidal M. Estudio Observacional sobre el dolor postoperatorio leve o moderado desde el punto de vista del anestesiólogo en España. PATHOS. Rev Soc Esp Dolor. 2007;14:550-67.
28. Morrison RS, Magaziner J, Gilbert M, Koval KJ, McLaughlin MA, Orosz G, et al. Relationship between pain and opioid analgesics on the development of delirium following hip fracture. J Gerontol A Biol Sci Med Sci. 2003;58:76-81.
29. Valentín López B, García Caballero J, Muííoz Ramón JM, Aparicio Grande P, Díez Sebastán J, Criado Jiménez A. Postoperative pain management in a tertiary care hospital: initial situation prior to starting a quality assurance program. Rev Esp Anestesiol Reanim. 2006;53:408-18.
30. Brennan F, Cousins MJ. Pain relief as a human right. Rev Soc Esp Dolor. 2005;12:17-23.
31. Soler E, Faus MT, Montaner MC, Morales F, Martínez-Pons V. Prevalencia, tratamiento y factores determinantes del dolor postoperatorio en un servicio de cirugía general y aparato digestivo. Rev Soc Esp Dolor. 2001;8:317-26.
32. Manion SC, Brennan TJ. Thoracic epidural analgesia and acute pain management. Anesthesiology. 2011;115:181-8.
How to Cite
1.
Machado-Alba JE, Machado-Duque ME, Calderón Flórez V, Gonzalez Montoya A, Cardona Escobar F, Ruiz García R, et al. Are we controlling postoperative pain?. Colomb. J. Anesthesiol. [Internet]. 2013 Apr. 1 [cited 2024 Apr. 23];41(2):132-8. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/879
Downloads
Download data is not yet available.
Published
2013-04-01
How to Cite
1.
Machado-Alba JE, Machado-Duque ME, Calderón Flórez V, Gonzalez Montoya A, Cardona Escobar F, Ruiz García R, et al. Are we controlling postoperative pain?. Colomb. J. Anesthesiol. [Internet]. 2013 Apr. 1 [cited 2024 Apr. 23];41(2):132-8. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/879
Issue
Section
Original
Altmetric
| Article metrics | |
|---|---|
| Abstract views | |
| Galley vies | |
| PDF Views | |
| HTML views | |
| Other views | |
