Evaluation of Analgesics Prescription Pattern and Surgical Patients' Responses in Tertiary Hospitals in Southeast Nigeria

Abstract

Background: Adequate analgesics help the patients to recover quickly from surgery with less discomfort and pain. It helps the patient breathe well, cough, turn and ambulate early to enable quick recovery. Inadequate prescribed analgesic delays recovery and leads to postoperative complications. Despite documented evidence that adequate pain control helps in the quick recovery of surgical patients, it has been reported that doctors' prescriptions of analgesics for postoperative patients are inadequate for the level of pain experienced by the patients. This informed the establishment of pain medication prescription standards by accrediting agencies in some developed countries. Nigeria has no binding standards, and patients' postoperative pain is managed by what doctors and nurses deem adequate. It has been reported that the patients' pain medication needs in Nigeria are unmet. The study, therefore, seeks to evaluate the postoperative analgesics prescription pattern and patients' responses in three tertiary hospitals in Southeast Nigeria. Objective: The study's main purpose was to evaluate the pattern of postoperative prescription of analgesics and surgical patient response to these drugs in tertiary hospitals in Southeast Nigeria. Method: A descriptive cross-sectional survey research design was used for the study. Study sample was 120 surgical patients selected equally from three randomly selected tertiary hospitals from the five States in Southeast Zone. Questionnaire and checklist were the instruments used for data collection in the study. The instrument's reliability was tested using the split-half technique and was analyzed using Spearman's rank-order correlation coefficient, which yielded a value of 0.85. All the hypotheses were tested at 0.05 level of significance. Results: The results show that drugs commonly prescribed by doctors for pain relief were pentazocine, paracetamol, diclofenac, and tramadol. The prescriptions were done mainly by Surgeons and Resident doctors. There was agreement on the pattern of prescription of analgesics by Surgeons in the southeast Nigerian hospitals. The results also show that there is a significant difference (p<0.05) in the mean patients' responses to the prescribed analgesics but found no significant difference (p>0.05) in pain prescription by doctors in the management of surgical patients in tertiary hospitals in Southeast Nigeria. Patients reported experiencing severe pains (41.7%) on the first, moderate pains (45.8%) on the second day, and mild pain (25%) on the third day after surgery. Conclusion: It was concluded that there is no significant difference in the pattern of the prescribed pain relief drugs and their dosages among surgeons from different tertiary hospitals. The patients' responses showed that the prescription pattern does not lead to good pain control in the first three days post-surgery. Recommendation: It was recommended that doctors review their prescription pattern for surgical patients, particularly within the first 72 hours after surgery when the pain is at its peak. Nurses should apply non-pharmacological pain management methods within this period to improve the comfort of the surgical patients.