Abstract
BackgroundCurrent pain assessment and treatment does not address every patient’s requirements. Although the Polish national guidelines for post-operative pain management have been published, many patients experience severe pain in the postoperative period. The main goal of our study was to assess pain severity among patients from different types of hospitals (primary, secondary, and tertiary centers) after similar types of surgeries. We also aimed to determine if there were any differences in pain severity associated with anesthesia technique, type of surgery, and the patient’s age and sex.MethodsThis was a prospective, observational study. A questionnaire form was used to collect demographic data, type of hospital, surgery, anesthesia, and patient satisfaction of pain control in the postoperative period. The visual analogue scale (VAS) was used to measure pain severity at four time points after surgery (4, 8, 12, and 24 h).ResultsThe study was conducted from November 2015 to June 2016 in seven hospitals in Eastern Poland, and 269 women and 293 men participated. At the 4-h measurement, 39.32% of patients assessed the pain as moderate and 19.75% as severe. A difference was found in pain intensity between patients treated in primary and secondary hospitals. Vascular surgery patients had the lowest pain intensity (19 (13–26)), especially in comparison to those undergoing thoracic surgery (30 (27–33)). A sudden elevation in pain severity among patients anesthetized with single-shot spinal technique was observed. Only 4.9% of participants received strong opioids during the first 24 h after surgery.ConclusionsPostoperative pain control seems to be unexpectedly poor after single-shot subarachnoid anesthesia. Despite concerns, the use of analgesics may be insufficient in some groups of patients. Our study indicates new variables that influence the severity of pain, such as operated region, anesthetic technique, and type of surgical department. The results obtained in our study are in discrepancy with recommendations presented by the national guidelines for post-operative pain management.
Highlights
Current pain assessment and treatment does not address every patient’s requirements
The guidelines endorsed by the Polish Society of Anesthesiology and Intensive Therapy in 2014 comprise many analgesic approaches that are relevant in most clinical scenarios [7]
Results presented in our study show that many patients still experience moderate or severe pain in the postoperative period, even though there are guidelines and methods to treat pain after surgical procedures
Summary
The Polish national guidelines for post-operative pain management have been published, many patients experience severe pain in the postoperative period. The main goal of our study was to assess pain severity among patients from different types of hospitals (primary, secondary, and tertiary centers) after similar types of surgeries. We aimed to determine if there were any differences in pain severity associated with anesthesia technique, type of surgery, and the patient’s age and sex. According to different variables, such as type of surgery, pain-measurement tool, time of assessment, and patient’s sex and age, pain may be classified as moderate and severe in approximately 60 to 80% of cases [3,4,5,6]. The most important factors are, in their opinion, their lack of independence in decisions concerning pharmacological treatment, as well as poor cooperation from physicians
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