Post-operative pain management by acute pain service in a University Hospital, Thailand

Abstract

Summary The acute pain service (APS) was established at Srinagarind University Hospital in January 2004 and this is the systematic assessment for the first year. We assessed the quality of post-operative pain management provided by the APS. The retrospective, descriptive study included the demographic data and the peri-operative pain management techniques used by the APS between January and December 2004. We determined the incidence of side effects and patient-satisfaction based on self-reports of pain at rest and with movement, using either a numerical rating scale (NRS) or a verbal rating scale (VRS). The study included 1540 patients (14% of all patients receiving anaesthesia care) and of these 60% were females, 69% between 22 and 64 years of age, and 31% undergoing lower abdominal surgery. Three commonly used techniques were intravenous patient-controlled analgesia (IV PCA) (43%), single dose spinal morphine (18%) and intermittent epidural morphine (14%). More than half of the patients (58%) received 1 day of service. The mean NRS score at rest and with movement on the first post-operative day was 2.7 ± 2.5 and 5.2 ± 2.9, respectively. Patient satisfaction was ‘very satisfactory’ (80%). Reasons for dissatisfaction included: pain experienced during the epidural block, unrelieved post-operative pain and severe nausea/vomiting.