Acute Postoperative Pain Research Articles

Autonomic Parameters Correlated to Acute Postoperative Pain in the Postanesthesia Care Unit: A Systematic Review.

The rising volume of orthopaedic surgeries highlights the importance of optimal postoperative pain management, especially for trauma patients who frequently suffer inadequate analgesia and delayed recovery. This multicenter study aims to evaluate the prevalence of acute postoperative pain and identify contributing factors in traumatic and non-traumatic orthopaedic patients. This multicenter study analysed adult orthopaedic surgery patients from the China Acute Postoperative Pain Study between September 2019 and August 2023. Patients with preoperative acute physical injuries requiring surgical intervention were defined as trauma patients. Using multivariate regression, we compared pain outcomes between trauma/non-trauma groups and identified risk factors for moderate-to-severe postoperative pain. Among 10,892 orthopaedic patients (2833 trauma, 8059 non-trauma), trauma patients showed higher rates of moderate-to-severe pain (57.3% vs. 50.1%), experienced more anxiety and helplessness, and had a greater desire for additional pain management than non-trauma patients. Trauma was associated with the development of moderate-to-severe postoperative pain in both uni- and multivariate analyses (p < 0.001). Risk factors for postoperative pain differed: age over 65 years and preoperative chronic pain were significant in non-trauma patients, whereas intraoperative non-opioid analgesics and local anaesthetic infiltration were associated with a decreased incidence of moderate-to-severe postoperative pain in trauma patients. Over half of orthopaedic surgery patients experienced moderate to severe postoperative pain, with trauma patients reporting higher levels and greater impacts on their activities and emotional state, along with a greater need for additional pain relief. Distinct risk factors for trauma and non-trauma patients highlight the need for personalised perioperative analgesic strategies. This study advances perioperative pain management by identifying trauma as an independent risk factor for moderate-to-severe postoperative pain in orthopaedic patients, with distinct risk profiles for trauma and non-trauma subgroups. Trauma patients reported higher pain levels, greater distress and increased analgesic needs. These findings directly inform clinical practice, emphasising the need for personalised, risk-stratified pain management to improve recovery. The results provide an evidence-based framework for optimising analgesia in both trauma and elective orthopaedic surgery.

Pain following pediatric adenotonsillectomy is prevalent, frequently severe, and often inadequately managed. The effectiveness of propofol or sevoflurane anesthesia in acute postoperative pain management is unknown. We conducted a single-blind, randomized controlled trial to examine the postoperative analgesic effectiveness of propofol or sevoflurane anesthesia. 144 children aged 2-7 years were enrolled and randomly assigned to receive either propofol or sevoflurane anesthesia, with 142 completing the study. The primary outcome was the proportion of acute postoperative pain measured by the Face, Legs, Activity, Cry, and Consolability (FLACC) scale scores > 3 within 24 h between the two groups. Secondary outcomes included postoperative pain assessed by the parent's postoperative pain measure (PPPM) scale and numeric rating scale (NRS) on the 1, 2, 3, 7, and 14 postoperative days, as well as perioperative adverse events. The incidence of acute pain FLACC > 3 within 24 h showed comparable results between both groups (30 of 71 [42.3%] vs. 34 of 71 [47.9%]; odds ratio [OR] = 0.78, 95% confidence interval [CI]: [0.28, 2.18]; p = 0.500). The propofol group demonstrated higher pain scores on postoperative days 2-3, with between-group median differences (ΔNRS at activity = 1, ΔPPPM = 1) below minimal clinically important difference thresholds (ΔNRS > 1, ΔPPPM > 3). The incidence and intensity of acute postoperative pain in the first 24 h after adenotonsillectomy did not differ significantly between pediatric patients who received maintenance anesthesia with propofol or with sevoflurane. The two general anesthesia techniques exhibited comparable clinical efficacy with respect to pain prognosis within 2 weeks. The Chinese Clinical Trial Registry (ChiCTR2300075847, Date of registration: September 3, 2023).

Smoking is known to increase the risk of numerous postoperative complications, including increased rates of infection, cardiovascular events, and pulmonary complications. In addition, there may be an effect of smoking on pain in the perioperative period. Through this meta-analysis, we sought to investigate what is known about the relationship between smoking and acute postoperative pain. Articles published between January 2003 and December 2023 that compared smokers to nonsmokers and utilized pain scores and/or measured postoperative opioid consumption were selected for review. 95% confidence intervals were utilized to determine statistical significance in standardized mean differences for each outcome between smokers and nonsmokers. The meta-analysis included five studies that assessed postoperative pain scores and opioid requirements in smokers and nonsmokers. In the analysis of pain scores, smokers consistently had higher pain scores overall on all postoperative days (POD) 0 (0.46 [95% CI: 0.26-0.66]), POD1 (0.32 [0.17-0.46]), and POD2 (0.38 [0.24-0.52]). Smokers also demonstrated higher opioid requirements compared to nonsmokers on POD0 (0.62 [0.43-0.80]), POD1 (0.49 [0.36-0.62]), and POD2 (0.70 [0.56-0.84]). Four additional studies were included in our systematic review, which further revealed an association between smoking history and postoperative pain. Smokers demonstrate increased postoperative pain, as assessed by pain scores and opioid requirements. The ability to anticipate increased postoperative pain in this population has the potential to improve postoperative outcomes for patients with a smoking history.

This study aims to analyze the risk factors for acute pain after percutaneous vertebroplasty in patients with thoracolumbar spine fracture and create a predictive model for validation. Clinical data of thoracolumbar spine fracture patients admitted to our hospital from January 2023 to December 2024 were retrospectively collected, and the visual analog score was used to assess the pain within 48 hours after the operation, and a visual analog score of >3 was defined as acute pain. Independent risk factors were screened by univariate and multivariate logistic regression analyses, and the model was visualized using a nomogram. The performance of the model was assessed by calculating the area under the curve from the receiver operating characteristic curve, and the model fit was verified using the Hosmer–Lemeshow goodness-of-fit test. To improve the reliability of the validation results, Bootstrap combined with 10-fold cross-validation was used for internal validation, and calibration curve and decision curve analyses were applied to assess the clinical utility of the model. Two hundred ninety-four patients were included, of which 186 (63.27%) experienced acute pain after surgery. Univariate and multifactorial logistic regression analyses showed that 5 independent risk factors were associated with acute postoperative pain: body mass index > 24 kg/m2 (odds ratio [OR], 1.834; 95% confidence interval [CI], 1.230–4.324), number of fractured vertebra > 1 (OR, 3.902; 95% CI. 1.873–9.423), unsatisfactory cement distribution (OR, 3.004; 95% CI, 1.483–6.837), vertebral compression height > 4 mm (OR, 3.319; 95% CI, 1.376–5.766), and fracture site in lumbar spine (OR, 1.457; 95% CI, 1.137–2.769). The occurrence of acute pain after percutaneous transluminal vertebroplasty in patients with thoracolumbar spine fracture is associated with a variety of factors, and the prediction model constructed in this study has good prediction accuracy, which can help to identify high-risk patients at an early stage and intervene.

Opioid-free versus opioid-based anaesthesia and analgesia for patients at low risk for acute postoperative pain undergoing laparoscopic surgery: A randomised controlled trial.

Persistent abdominal pain after laparoscopic cholecystectomy (PAPLC) incidence is estimated between 3% and 56%. Data concerning PAPLC intensity and its neuropathic characteristics is scarce, and the role of intravenous lidocaine on PAPLC is not clarified. The authors aim to evaluate PAPLC prevalence, intensity, risk factors, and neuropathic pain (NP) characteristics. Intravenous lidocaine's impact on acute and persistent pain and opioid consumption was explored. In a 3-year follow-up, participants (n = 93) were enquired by telephone after informed consent. Sociodemographic characteristics, intraoperative and postoperative analgesia, acute pain control, preoperative chronic abdominal pain (PCAP), intensity (numeric pain scale score [NPSS]), and Douleur Neuropathique-4 questionnaire were analyzed. A NPSS ≥1 indicated a diagnosis of PAPLC. A 15.05% prevalence of PAPLC was observed. About 57.1% of PAPLC patients reported moderate-to-severe pain. All PAPLC patients reported NP features. The intraoperative fentanyl dose (P = 0.029), postoperative acute pain in the first 48 hours (P = 0.022), postoperative nausea and vomiting during the first 48 hours (P = 0.019), height (P = 0.016), and PCAP (P = 0.025) were the identified PAPLC risk factors. Dexamethasone administration differed between PAPLC and NPAPLC groups (P = 0.049). Intravenous lidocaine (n = 27) caused a lower need for opioid rescue (P = 0.050) in post-anesthesia care unit (PACU). This study's findings indicate a high PAPLC prevalence and a significant percentage of moderate-to-severe pain. Neuropathic pain characteristics should not be overlooked. The observed PAPLC risk factors follow the evidence. Intravenous lidocaine reduced the need for rescue opioid analgesia in the PACU and nonopioid analgesia in the postoperative period.

Introduction: Ventral hernias are common surgical conditions requiring either open (Onlay) or laparoscopic (Intraperitoneal Onlay Mesh (IPOM) Plus) repair. This study compares their outcomes to guide clinical decision-making. Methods: A prospective study was conducted at Ganesh Shankar Vidyarthi Memorial Medical College, Kanpur and Jeevanshree Hospital, Maharashtra, randomized 94 patients with ventral hernias (defect size 3-7 cm, age 18-60 years) into Onlay (n=47) or IPOM Plus (n=47) groups. Outcomes included operative time, hospital stay, surgical site infection (SSI), hematoma, seroma, pain (Visual Analog Scale (VAS)), return to activities/work, and recurrence. Data were analyzed using T-tests and chi-square tests (p&lt;0.05). Results: IPOM plus resulted in longer operative times (94.19±12.34 vs. 53.85±10.56 min, p&lt;0.001), but shorter hospital stays (2.09±0.87 vs. 4.18±1.23 days, p&lt;0.001) and faster return to daily activities (8.34±2.01 vs. 11.40±2.56 days, p&lt;0.001) and work (14.72±3.12 vs. 18.36±3.89 days, p=0.030). The IPOM Plus group had lower rates of hematoma (0% vs. 25.5%, p&lt;0.001), seroma (10.6% vs. 34%, p=0.006), and SSI (4.3% vs. 27.7%, p=0.002). Acute postoperative pain was lower in IPOM plus, while chronic pain and recurrence rates were comparable. Conclusions: IPOM plus offers reduced complications and faster recovery, despite longer operative times, making it preferable for suitable patients. Recurrence rates are comparable.

ABSTRACT Background: Despite being considered routine, breast surgery is associated with a high incidence of acute and chronic postoperative pain, which can significantly impact recovery and quality of life. Regional anesthesia techniques have become increasingly relevant within multimodal analgesic strategies, yet clinical practice remains heterogeneous and lacks clear guidance. To address this, we aimed to develop a multidisciplinary, evidence-based consensus on the role of regional anesthesia in breast surgery. Methods: An expert panel was appointed by the Italian Chapter of the European Society of Regional Anaesthesia, including anesthesiologists and breast surgeons (in partnership with the Italian National Association of Breast Surgeons). A four-round Delphi method was applied to refine an initial set of 24 PICO-formulated questions. Each question was evaluated for relevance and clarity using a 9-point Likert scale (1 = not relevant/clear, 9 = extremely relevant/clear). Finalized questions underwent systematic review or network meta-analysis depending on data availability. Results: Eleven clinically relevant and clearly formulated PICO questions were identified after four Delphi rounds. These questions encompass acute and chronic pain control, block safety in anticoagulated patients, awake surgery, and the comparative efficacy of single-shot versus continuous blocks, among others. Each question will guide a systematic review and support the development of graded consensus statements. Conclusion: This consensus project establishes a transparent, multidisciplinary framework for guiding the use of regional anesthesia in breast surgery. The ultimate objective is to formulate a set of consensus statements, graded according to evidence strength, which will serve as a foundation for future guidelines and standardized clinical decision-making.

Background Transoral robotic surgery (TORS) is performed for both benign as malignant diseases. It has been suggested that patients treated for benign indications may report higher postoperative pain, though supporting evidence is limited. Aims/Objectives To evaluate which factors are associated with acute postoperative pain severity following TORS. Material and methods A retrospective observational cohort study was conducted in patients undergoing TORS. Maximum postoperative pain scores (numerical rating scale, NRS 0–10) were recorded for postoperative day (POD) 1,2,3. Clinically well-controlled pain was defined as NRS < 3. Variables including surgical indication (benign or malignant), gender, age, BMI, analgesic use, chronic pain and antidepressant use were analysed. Univariable and multivariable regression analysis were performed for NRS ≥ 3. Results Of the 119 cases, the mean maximum POD1 pain score was 2.7 (SD 1.89). Univariable analysis showed higher POD1 were associated with benign disease, chronic pain, pain relief, female gender and age. On multivariable regression analysis, only female gender was significantly associated with NRS ≥3. Conclusions and significance Female gender was found to be the only independent predictor of higher postoperative pain, other factors, including surgical indication were not.

Open radical nephrectomy often results in significant acute postoperative pain. Regional anesthesia offers an alternative analgesic approach in these situations. This study aims to assess and compare the effectiveness of ultrasound-guided rhomboid intercostal sub-serratus (RISS) block with Erector Spinae Plane Block (ESPB) in patients undergoing open radical nephrectomy. This randomized clinical trial included 42 patients scheduled for open radical nephrectomy (RN). Patients were randomly assigned to one of two groups: the ESPB Group (n = 21), which received an ESPB with 30ml of bupivacaine 0.25%, or the RISS Group (n = 21), which received a RISS block with 30ml bupivacaine 0.25%. Total morphine consumption was set as the primary outcome while pain scores, perioperative hemodynamics and time to postoperative analgesia were considered as secondary outcomes. Total morphine consumption within the first 24 postoperative hours was significantly lower for the ESPB group (16.4 ± 2.5mg) compared to the RISS group (18.2 ± 1.8mg), p = 0.011. VAS pain scores at rest were significantly lower in the ESPB group at 12 and 18h (p = 0.002, p = 0.018) respectively. VAS scores with movement were significantly lower for the ESPB group at 8h,12h, and 18h (p = 0.011, p = 0.001, and p = 0.018 respectively). The first time to receive postoperative analgesia was significantly longer in the ESPB group (7.3 ± 2.1h) than in the RISS group (6.0 ± 2.1h), p = 0.048. Both groups were comparable in the number of PCA boluses, the number of patients requiring intraoperative fentanyl increments, or recovery time. Ultrasound-guided ESPB provides slightly superior postoperative analgesia compared with RISS block in patients undergoing open radical nephrectomy via subcostal anterior incision for renal malignancies. The trial was registered at Clinical Trials.gov. https://clinicaltrials.gov/study/NCT05822011 , trial ID (NCT05822011, 14 March 2023).

Comparison of total morphine milligram equivalents at hospital discharge between opioid-naive and opioid-experienced surgical patients: a single-centre retrospective cohort study

BackgroundAcute postoperative pain is common in surgical patients, and intraoperative noise isolation has been shown to reduce pain for up to 24 h postoperatively. However, acute postoperative pain primarily occurs during the first three days after surgery, and it remains unclear whether intraoperative noise isolation affects the incidence of moderate-to-severe acute postoperative pain during this period. Therefore, this study aimed to investigate whether the use of noise-cancelling earmuffs during laparoscopic surgery reduces the incidence of moderate-to-severe acute postoperative pain.MethodsA single-center clinical randomised controlled trial was conducted in Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University. The study included 86 patients aged 18–65 years who underwent elective laparoscopic surgery under general anaesthesia, had an ASA classification I-III, and received patient-controlled intravenous analgesia (PCIA). Participants were randomly assigned to either a noise isolation group or a control group. The noise isolation group wore noise-cancelling earmuffs to attenuate intraoperative noise from induction until the end of surgery, while the control group received conventional anaesthesia management without earmuffs. The primary outcome was the incidence of numeric rating scale (NRS, 0–10) pain scores ≥ 4 at 72 h postoperatively, measured using a 10-point numeric rating scale. Secondary outcomes included the incidence of NRS pain scores ≥ 4 at 24 h and 48 h postoperatively and the proportion of different tiers of NRS pain scores (mild [1–3], moderate [4–6] and severe [7–10]), daily frequency of additional rescue analgesic use over postoperative days 1–3, the maximum resting pain score and the maximum movement-evoked pain score at 24, 48, and 72 h postoperatively and total opioid consumption during the first 72 h postoperatively.ResultsThe noise isolation group had a significantly lower incidence of moderate-to-severe pain on the third postoperative day (7.1% vs. 25%, P < 0.05) compared with the control group. The incidences of moderate-to-severe pain on the first (33.3% vs. 56.8%, P < 0.05) and second (19.0% vs. 47.7%, P < 0.05) postoperative days were significantly lower in the noise isolation group compared to the control group. Noise isolation reduced the proportion of moderate pain (33.3% (14/42) vs. 56.8% (25/44), P = 0.003; 19% (8/42) vs. 40.9% (18/44), P = 0.027; 4.8% (2/42) vs. 22.7% (10/44), P = 0.016) on postoperative days 1 to 3 compared with the control group. Median additional rescue analgesic use was lower during the three postoperative days in the noise isolation group (0 [0–2] vs. 1.33 [0–2], P = 0.023). The median maximum resting pain scores in the noise isolation group were significantly lower in the postoperative 24 and 72 h periods (1 [0–2] vs. 2 [1–3], P < 0.05; 0 [0–1] vs. 1 [0–2], P < 0.05), as was the median maximum movement-evoked pain scores at 48 and 72 h postoperatively (3 [1.75–3] vs. 3 [2–4], P < 0.05; 2 [1.75–3] vs. 3 [2–3.75], P < 0.05). Opioid dosage (70 [61.6–74] vs. 73.2 [68–76.6], P < 0.05) and the number of PCIA pump button presses (0 [0–0] vs. 1 [0–2.75], P = 0.002) in the noise isolation group were significantly lower in the third postoperative day compared with the control group. Finally, sleep disturbances were less frequent in the noise-isolation group on the third postoperative day (19.0% vs. 40.9%, P < 0.05) compared to the control group.ConclusionIntraoperative noise isolation using noise-cancelling earmuffs reduces the incidence of moderate-to-severe pain and reduces pain severity distribution one to three days after laparoscopic surgery, and it also lowers both total opioid consumption and the need for additional rescue analgesia during the three days after surgery.Trial registrationRegistered in the Chinese Clinical Trial Registry ChiCTR2500097844 (Date: 26/02/2025).

Perioperative analgesia in high-risk patients, what clinicians and searchers must know? A narrative review.

To investigate the reproducibility and diagnostic accuracy of the Unesp-Botucatu Feline Pain Scale short form (UFEPS-SF) and the Visual Analogue Scale (VAS) among untrained laypersons, cat owners, veterinary students and experienced veterinarians. Blind and randomized. Videos of 10 female cats. Three self-declared female and three male raters were included per group of experienced veterinarians, students, cat owners and laypersons (n = 24). Participants assessed 40 videos of female cats that underwent ovariohysterectomy: preoperative, postoperative, post-rescue analgesia, and 24 hours postoperatively. A multilevel generalized linear model followed by Bonferroni post hoc test was used to evaluate differences in UFEPS-SF scores between groups. Interobserver agreement was calculated by intraclass correlation coefficient (ICC) between pairs of observers within each group. Area under the curve (AUC) for the receiver operating characteristic curves, specificity (no pain) and sensitivity (pain) were calculated. ICC for UFEPS-SF was higher for veterinarians and students than for laypersons and cat owners, although all results were very good (≥0.81). Reliability of the VAS was very good for experienced observers only. Females assigned higher median scores than males only at 24 hours postoperatively. UFEPS-SF specificity [confidence interval (CI)] and sensitivity (CI) were 0.83-1 (0.7-1) and 0.98-1 (0.91-1), respectively, and diagnostic accuracy [AUC (CI)] was excellent across all groups [0.99-1 (0.97-1)], with no significant differences between groups. The predictive capacity (AUC) of the VAS followed the order: experienced > students > cat owners = laypersons. VAS AUC values were lower than those of UFEPS-SF. The UFEPS-SF can be reliably used by untrained laypersons, cat owners and students with no experience to identify acute postoperative pain in cats. The reproducibility, sensitivity and diagnostic accuracy of the VAS were suboptimal and inferior to those of the UFEPS-SF, except among experienced observers.

ObjectiveTo investigate the trajectories of acute postsurgical pain (APSP) following total knee arthroplasty (TKA), its influencing factors, and its impact on knee function recovery at 3 months postoperatively.MethodsA convenience sample of patients undergoing TKA at a tertiary hospital in Panzhihua City between June 2024 and February 2025 was recruited. Preoperatively (T0), baseline data including demographics, anxiety, depression, family care index, pain level, and pain catastrophizing were collected. Postoperative pain levels were assessed on days 1 (T1), 2 (T2), 3 (T3), and 5 (T4), while joint functional outcomes were evaluated at 3 months postoperatively (T5). Growth mixture modeling (GMM) was used to identify distinct APSP trajectory subgroups, logistic regression was used to analyze influencing factors, and multiple linear regression was used to examine the association between APSP trajectories and joint functional outcomes.ResultsAmong 227 enrolled patients, two APSP trajectory subgroups were identified: a moderate-high persistent pain group (45.16%) and a moderate-low rapid relief group (54.84%). Logistic regression revealed that age, preoperative pain level, pain catastrophizing, and family care index significantly influenced APSP trajectories. APSP trajectory membership positively predicted 3-month knee joint functional outcomes.ConclusionTKA patients exhibit two distinct APSP trajectory patterns, which serve as significant predictors of joint functional outcomes. Clinicians should identify the persistent pain subgroup and implement enhanced multimodal analgesia to prevent chronic postsurgical pain and optimize rehabilitation outcomes.

Background and Aim: Breast surgery is frequently associated with high postoperative pain, which if not adequately managed can delay recovery and increase the risk of chronic postsurgical pain. This study evaluated whether perioperative opioid application and/or incisional infiltration with long-acting local anaesthetics can improve postoperative pain control as part of an effective preventive strategy. Study Design and Methods: A total of 536 consecutive patients undergoing breast surgery at Jena University Hospital were prospectively evaluated on the first postoperative day using a standardized pain questionnaire as part of the QUIPS (Quality Improvement in Postoperative Pain Management) project. Analgesic strategies were introduced sequentially in addition to the standard postoperative pain management (group A, first 9 months), addition of prophylactic oxycodone (group B, 17 months), combined oxycodone and wound infiltration with ropivacaine (group D, 4 months), and finally, ropivacaine alone (group C, 6 months). Results: All three intervention groups showed significant improvements over standard care, with more patients pain-free at 24 h (group A: 9.5%, B: 18.5%, C: 16.3%, D: 25.6%; p = 0.01), fewer requiring opioids on demand (A: 26.5%, B: 15.9%, C: 4.1%, D: 4.7%; p < 0.05), and a significantly delayed first opioid request. The incidence of nausea and vomiting was significantly lower in the ropivacaine-only group compared to other regimens (p = 0.03). Ropivacaine infiltration alone (group C) was associated with the fewest opioid-related side effects. Conclusion: Intraoperative and drain-based ropivacaine wound infiltration, alone or in combination with pre-emptive oxycodone, effectively reduced acute postoperative pain and opioid requirements after breast surgery, while reducing opioid-related side effects like nausea and vomiting. As part of a multimodal, opioid-sparing strategy, this technique demonstrated favourable patient-reported outcomes and may contribute to faster recovery, fewer side effects, and improved patient-reported satisfaction. These findings support the clinical relevance of preventive local anaesthetic techniques in breast surgery.

A key component of multimodal analgesia that enhances postoperative pain control is the wound infiltration of local anesthetics after surgery. Diphenhydramine is known to have local analgesic effects; however, it is unclear how well it works to lessen postoperative catheter-related bladder discomfort (CRBD) following pyelolithotomy. From 2022 to 2024, 82 eligible patients participated in this double-blind randomized controlled trial. Participants were randomly assigned to receive either diphenhydramine (20 ml, 0.5%) or lidocaine (20 ml, 1%) for wound infiltration prior to closure. As the primary outcome, the Visual Analog Scale (VAS) for the recovery period and the first 24 h following surgery was assessed. There were no statistically significant differences in the baseline characteristics. VAS demonstrated that diphenhydramine offered pain relief similar to that of lidocaine during the postoperative period, with significantly lower scores at 18 h (p < 0.001). The occurrence of CRBD was markedly reduced in the diphenhydramine group (p < 0.001), as was the intensity of CRBD (p < 0.001). Furthermore, the diphenhydramine group exhibited a significant reduction in analgesia requirements and total opioid consumption (p < 0.001). Compared to lidocaine, diphenhydramine infiltration considerably lowers postoperative pain and the requirement for opioids while increasing sedation levels following pyelolithotomy surgery.

Acute pain is a common complaint following surgery in patients with femur fractures and can hinder recovery if not managed effectively. This study aimed to describe the application of Benson’s relaxation therapy in reducing pain after Open Reduction and Internal Fixation (ORIF) for femur fracture. A nursing care case study was conducted on Mrs. S, an 82-year-old woman, in the Central Operating Theatre of Labuang Baji General Hospital, Makassar. Assessment was performed in the post-anesthesia care unit, followed by the identification of the nursing diagnosis Acute Pain (D.0077), intervention using Benson’s relaxation therapy combined with collaborative pharmacological analgesia (ketorolac), implementation, and one-hour evaluation. Results showed a reduction in pain intensity from a score of 6 to 4 on the Numeric Rating Scale, a change in pain pattern from continuous to intermittent, and improved vital signs along with decreased behavioral indicators of pain (grimacing, restlessness, and protective posture). These findings indicate that Benson’s relaxation therapy is an effective non-pharmacological intervention for managing acute postoperative pain, consistent with theoretical evidence that this technique reduces pain perception through muscle relaxation, deep breathing, and reinforcement of spiritual beliefs.

Feasibility and acceptability of an app for monitoring acute postoperative pain in major outpatient surgery.