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Abstract
Objectives: The objectives of the study were to evaluate and compare the utilization pattern of analgesic use in pre-operative, intraoperative, and post-operative wards of different surgical specialties.
 Methods: It was a prospective, cross-sectional, and observational study done for a period of 1 year and the data were obtained from case sheets of 386 patients admitted in surgical wards of the. Data were analyzed according to demography, type of surgery, and the WHO prescribing indicators. The percentage of analgesic prescribed from an essential medicine list or National list of essential medicine (NLEM), common analgesics, and fixed dose combinations (FDC) used in surgery, gynecology, ENT, and orthopedic wards in preoperatively, intraoperatively, and postoperatively, was assessed and the amounts of drugs consumed were converted into the number of daily defined dose (DDD) as per the 2010 version of ATC/DDD index.
 Results and Discussion: The female to male ratio of 1.21 and most of patients were in the category of middle-aged adults (49%). On the evaluation of WHO prescribing parameters, it was seen the average number of analgesics prescribed per prescription was 1.26, percentage of injectable analgesics and analgesics prescribed from NLEM were 81.09% and 90.64%, respectively. Perioperatively, injection diclofenac sodium was the most commonly used analgesic and its DDD was 460. The most common FDC used perioperatively was aceclofenac 325mg+serratiopeptidase 15 mg (5.04%) and Drug Controller General of India and the WHO approved FDCs were 80.28% and 75.53%, respectively.
 Conclusion: It is necessary to determine the prevalence and severity of post-surgical pain and implementation of standardized pain evaluation and treatment protocols which improve the post-operative patient care in the hospital setting.
Highlights
Post-operative pain is one of the end results of any surgical procedure and calls for efficient management
The percentage of analgesic prescribed from an essential medicine list (EML) or national list of essential medicine (NLEM) was assessed with following formula
On the evaluation of the WHO prescribing parameters, it was seen the average number of analgesics prescribed per prescription was 1.26
Summary
Post-operative pain is one of the end results of any surgical procedure and calls for efficient management. Inadequate pain control can result in increased morbidity and length of hospital stay as well as increasing risk of persistent post-operative pain. Persistent post-surgical pain lasts beyond typical healing period of 1–2 months, has become increasingly recognized as a significant issue after surgery and may exceed 30% after certain operations amputations, thoracotomy, mastectomy, and inguinal hernia repairs [2]. Multimodal pain management combines the use of various pharmacological mechanisms of action and additive or synergistic effects, which work by acting at different sites within central and the peripheral nervous system [3]. The use of procedure specific, multimodal pain management has almost become mandatory following surgery to enhance post-operative recovery
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