Management of postoperative pain in Spain.

Abstract

The management of postoperative pain is suboptimal world-wide. This survey was carried out to determine current management in Spanish hospitals. Spanish hospitals were divided into two groups: <200 beds (n=346) and >200 beds (n=186). A structured questionnaire was mailed to the heads of the anaesthesiology services of a random sample of 150 of hospitals of <200 beds, and all larger hospitals. Only 19% of hospitals with <200 beds responded and further analysis of this group was not possible; 53% of hospitals with >200 beds responded. In this sample (>200 beds), 45% of patients receive information on postoperative pain, given by the anaesthesiologist in 78% of cases. Over 70% of the hospitals do not have an acute pain unit and responsibility for postoperative pain lies with the anaesthesiology team in 71%, with the surgical team in 40% and with nursing in 33%, with an overlap of pain caretakers. Pain is measured on the surgical wards in 36% and recorded with the vital signs in 34%. On post-anaesthetic recovery wards, analgesia is most frequently given by intravenous (83%), epidural (78%) and continuous intravenous (66%) administration. On surgical wards, the most frequent routes that are available are epidural (72%), intravenous (69%) and intramuscular (58%). Only 28% of the anaesthesiology services are satisfied with the pain treatment carried out in their hospitals. No significant differences on postoperative pain management were observed between teaching and non-teaching institutions. The survey shows that the management of postoperative pain in hospitals with >200 beds in Spain is suboptimal and this is associated with dissatisfaction among many anaesthesiologists.