Postoperative Pain in the General Surgery Department of Fousseyni Daou Hospital in Kayes

Abstract

Goal: To study the management of postoperative pain in the general surgery department of the Fousseyni DAOU hospital in Kayes. Patients and Method: We conducted a prospective 6-month study from November 2022 to May 2023, involving 107 surgical patients, aged 15 to 81 years, who met the inclusion criteria. We assessed pain using the Visual Analogue Scale (VAS) at patient admission, at the second hour, and then every eight hours until seventy- second hours after analgesic use. Multimodal analgesia was the most widely used in the study. Administration of paracetamol alone and/or in combination with nefopam and/or ketoprofen and/or morphine. The evolution of pain as well as adverse effects after administration of analgesics were investigated. Results: The mean age of our patients was 35.9 years with extremes of 15 and 81 years. Male sex was the most represented at 64.5% with a sex ratio of 1.82 and the majority of patients were classified as ASA 1 (82.2%). VAS less than 3 (VAS≤ 4) was most observed during the first 2 hours postoperatively, i.e. 41.1% for VAS 0-2 and 28.9% VAS 3-4 at rest, respectively, and respectively 33.6% and 30.8% for no pain and mild pain. At 24 hours postoperatively, 87.2% of patients did not feel pain after the resting assessment, this figure increased from 89.8% at the 48th postoperative hour at rest, still after the use of analgesics. At the 72nd hour, we observed cases of pain, i.e. 0.9% of patients, which was related to a postoperative complication. The average cost of pain management was estimated at 23580 FCFA. Side effects observed were vomiting in 3 patients and drowsiness in one patient. Conclusion: Postoperative pain is still understudied, the evaluation with the visual analogue scale of patients before and after the use of analgesics has allowed us to better understand patients' pain and to improve pain management in the surgical department.