A national survey of postoperative pain managements in hospitals from the national health insurance database

Abstract

Background: A postoperative pain management has been considered as an important issue in surgery. However, any systematic information or standard method about it has not been so far provided for clinicians in Korea. This study aims to analyze the current practices of in-hospital postoperative pain controls and suggest clinical implications. Methods: A descriptive statistical analysis was adopted to review a nationwide distribution of postoperative pain control methods for the types of patients, surgery, hospitals, specialties, and analgesia. The data is based on the medical claims database of Health Insurance Review Agency (HIRA), which covers all reimbursement claims from hospitals in Korea. All inpatient surgery cases implemented during one year were included in the analysis. Results: It was reported that 1,539,662 cases out of total 1,891,596 inpatient surgery cases were associated with one or more types of analgesia in 2005. The most frequent type of inpatient surgery was bone surgery (24.4%). In all cases related with analgesia, bone surgery took the highest percentage of 28.6%. It was also revealed that the most frequently used postoperative pain management was oral or external use of NSAID (non steroidal anti-inflammatory drug), which was 75.0% of all analgesia treatments. An epidural PCA (patient controlled analgesia), IV PCA (intra-venous patient controlled analgesia) and epidural opioid bolus were 0.2%, 0.2% and 0.1%, respectively, of all analgesia treatments. Conclusions: The results would certainly be useful to develop a clinical practice guideline in postoperative pain management to enhance patient outcomes. (Korean J Anesthesiol 2008; 55: 458∼66)