Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-24T08:22:02.891Z Has data issue: false hasContentIssue false
  • English
  • Français

The prevalence of postoperative pain in a sample of 1490 surgical inpatients

Published online by Cambridge University Press:  01 April 2008

M. Sommer ,
J. M. de Rijke ,
M. van Kleef ,
A. G. H. Kessels ,
M. L. Peters ,
J. W. J. M. Geurts ,
H.-F. Gramke  and
M. A. E. Marcus
M. Sommer*
Affiliation:
University Hospital Maastricht, Department of Anaesthesiology and Pain Treatment, Maastricht, The Netherlands
J. M. de Rijke
Affiliation:
University Hospital Maastricht, Department of Anaesthesiology and Pain Treatment, Maastricht, The Netherlands
M. van Kleef
Affiliation:
University Hospital Maastricht, Department of Anaesthesiology and Pain Treatment, Maastricht, The Netherlands
A. G. H. Kessels
Affiliation:
University Hospital Maastricht, Department of Clinical Epidemiology and MTA, Maastricht, The Netherlands
M. L. Peters
Affiliation:
University Hospital Maastricht, Department of Medical, Clinical and Experimental Psychology, Maastricht, The Netherlands
J. W. J. M. Geurts
Affiliation:
University Hospital Maastricht, Department of Anaesthesiology and Pain Treatment, Maastricht, The Netherlands
H.-F. Gramke
Affiliation:
University Hospital Maastricht, Department of Anaesthesiology and Pain Treatment, Maastricht, The Netherlands
M. A. E. Marcus
Affiliation:
University Hospital Maastricht, Department of Anaesthesiology and Pain Treatment, Maastricht, The Netherlands
*
Department of Anaesthesiology, University Hospital Maastricht, PO Box 5800 6202 AZ Maastricht, The Netherlands. E-mail: [email protected]; Tel: +31 433875458; Fax: +31 433875457
Get access

Summary

Background and objective

To measure the prevalence of postoperative pain, an assessment was made of 1490 surgical inpatients who were receiving postoperative pain treatment according to an acute pain protocol.

Methods

Measurements of pain (scores from 0 to 100 on a visual analogue scale) were obtained three times a day on the day before surgery and on days 0–4 postoperatively; mean pain intensity scores were calculated. Patients were classified as having no pain (score 0–5), mild pain (score 6–40), moderate pain (score 41–74) or severe pain (score 75–100).

Results

Moderate or severe pain was reported by 41% of the patients on day 0, 30% on days 1 and 19%, 16% and 14% on days 2, 3 and 4. The prevalence of moderate or severe pain in the abdominal surgery group was high on postoperative days 0–1 (30–55%). A high prevalence of moderate or severe pain was found during the whole of days 1–4 in the extremity surgery group (20–71%) and in the back/spinal surgery group (30–64%).

Conclusion

We conclude that despite an acute pain protocol, postoperative pain treatment was unsatisfactory, especially after intermediate and major surgical procedures on an extremity or on the spine.

Keywords

PAIN ACUTE AND POSTOPERATIVEGUIDELINESOUTCOME ASSESSMENTQUALITY INDICATORS
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 25 , Issue 4 , April 2008 , pp. 267 - 274
Copyright
Copyright © European Society of Anaesthesiology 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Anonymous. Postoperative pain [Editorial]. Anaesth Intensive Care 1976; 4: 95.Google Scholar
2.Rowlingson, JC, Rawal, N. Postoperative pain guidelines – targeted to the site of surgery. Reg Anesth Pain Med 2003; 28: 265–267.Google Scholar
3.Rawal, N. Postoperative pain and its management. In: Rawal, N, ed. Management of Acute and Chronic Pain. London: BMJ Books, 1989.Google Scholar
4.Donovan, M, Dillon, P, McGuire, L. Incidence and characteristics of pain in a sample of medical-surgical inpatients. Pain 1987; 30: 69–78.CrossRefGoogle Scholar
5.Oates, JD, Snowdon, SL, Jayson, DW. Failure of pain relief after surgery. Attitudes of ward staff and patients to postoperative analgesia. Anaesthesia 1994; 49: 755–758.CrossRefGoogle ScholarPubMed
6.Svensson, I, Sjöström, B, Haljamäe, H. Assessment of pain experiences after elective surgery. J Pain Symptom Manage 2000; 20: 193–201.CrossRefGoogle ScholarPubMed
7.Cohen, FL. Postsurgical pain relief: patients’ status and nurses’ medication choices. Pain 1980; 9: 265–274.CrossRefGoogle ScholarPubMed
8.Dolin, SJ, Cashman, JN, Bland, JM. Effectiveness of acute postoperative pain management: I. Evidence from published data. Br J Anaesth 2002; 89: 409–423.CrossRefGoogle ScholarPubMed
9.Wheatley, RG, Madej, TH, Jackson, IJ, Hunter, D. The first year’s experience of an acute pain service. Br J Anaesth 1991; 67: 353–359.CrossRefGoogle ScholarPubMed
10.Idvall, E, Hamrin, E, Sjöström, B, Unosson, M. Quality indicators in postoperative pain management: a validation study. Scand J Caring Sci 2001; 15: 331–338.CrossRefGoogle ScholarPubMed
11.Snyder, C, Anderson, G, Idvall, E et al. Do quality improvement organizations improve the quality of hospital care for Medicare beneficiaries? Quality indicators in postoperative pain management: a validation study. JAMA 2005; 293: 2900–2907.CrossRefGoogle Scholar
12.Wit, Rd. Postoperative pain: a point of view (in Dutch). Ned Tijdschr Pijn Pijnbestrijding 2005; 24: 33–34.Google Scholar
13.Rawal, N. Acute pain services revisited--good from far, far from good? Reg Anesth Pain Med 2002; 27: 117–121.CrossRefGoogle ScholarPubMed
14.Collins, SL, Moore, RA, McQuay, HJ. The visual analogue pain intensity scale: what is moderate pain in millimetres? Pain 1997; 72: 95–97.CrossRefGoogle ScholarPubMed
15.Jensen, MP, Chen, C, Brugger, AM. Interpretation of visual analog scale ratings and change scores: a reanalysis of two clinical trials of postoperative pain. J Pain 2003; 4: 407–414.CrossRefGoogle ScholarPubMed
16.Owen, H, McMillan, V, Rogowski, D. Postoperative pain therapy: a survey of patients’ expectations and their experiences. Pain 1990; 41: 303–307.CrossRefGoogle ScholarPubMed
17.Angster, R, Hainsch-Müller, I. Postoperatives schmerzmanagement [Postoperative pain management]. Anaesthesist 2005; 54: 505–531.CrossRefGoogle Scholar
18.Fernandez, E. A classification system of cognitive coping strategies for pain. Pain 1986; 26: 141–151.CrossRefGoogle ScholarPubMed
19.Ong, EL, Lim, NL, Koay, CK. Towards a pain-free venepuncture. Anaesthesia 2000; 55: 260–262.CrossRefGoogle ScholarPubMed
20.Stamer, UM, Mpasios, N, Stuber, F, Maier, C. A survey of acute pain services in Germany and a discussion of international survey data. Reg Anesth Pain Med 2002; 27: 125–131.Google Scholar
21.Rosenquist, RW, Rosenberg, J. Postoperative pain guidelines. Reg Anesth Pain Med 2003; 28: 279–288.Google ScholarPubMed
22.Hannan, EL, Magaziner, J, Wang, JJ et al. Mortality and locomotion 6 months after hospitalization for hip fracture: risk factors and risk-adjusted hospital outcomes. JAMA 2001; 285: 2736–2742.CrossRefGoogle ScholarPubMed
23.Poobalan, AS, Bruce, J, King, PM et al. Chronic pain and quality of life following open inguinal hernia repair. Br J Surg 2001; 88: 1122–1126.CrossRefGoogle ScholarPubMed
24.Bruce, J, Drury, N, Poobalan, AS et al. The prevalence of chronic chest and leg pain following cardiac surgery: a historical cohort study. Pain 2003; 104: 265–273.CrossRefGoogle ScholarPubMed
25.Kalkman, CJ, Visser, K, Moen, J et al. Preoperative prediction of severe postoperative pain. Pain 2003; 105: 415–423.CrossRefGoogle ScholarPubMed
26.Pavlin, DJ, Sullivan, MJ, Freund, PR, Roesen, K. Catastrophizing: a risk factor for postsurgical pain. Clin J Pain 2005; 21: 83–90.CrossRefGoogle ScholarPubMed
27.http://www.postoppain.org. Postoperative Pain Management, 2007.Google Scholar