Remifentanil and worse patient-reported outcomes regarding postoperative pain management after thyroidectomy

Abstract Background The annual number of surgical operations performed is increasing throughout the world. With this rise in the number of surgeries performed, so too, the challenge of effectively managing postoperative pain. Healthcare professionals and patients in education might help in controlling postoperative pain effectively. However, data from low-income countries investigating the impact of educational intervention on postoperative pain are very scanty, and reports from the developed settings are inconclusive. The study has investigated the impact of preoperative patient education and health care professionals education on improving the quality of postoperative pain management; in patients scheduled for major elective orthopedic, gynecologic and general surgery; as measured by patient-reported outcomes. Methods This was a quasi-experimental, non-equivalent control group design with before and after measures. We have recruited 700 consecutive patients; who are eighteen years or more, scheduled for general, orthopedic and gynecologic surgery. Outcome measures were patient-reported outcomes (postoperative pain intensity, pain interference, and perception of care) and adequacy of pain management used. Results Generally, no significant difference was observed in most outcome measures except for the worst level of pain, least level of pain, patient participation in decision making and feeling of drowsiness between the treatment and control group. Conclusion Results of this study contained very important information in understanding the effectiveness of educational interventions in the postoperative setting. The treatment was successful in increasing patients participation in decision making, as anticipated. However, its impact on decreasing pain intensity was only noted at the last measurement point after surgery.

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Patient-reported postoperative pain management outcomes during standard and evening-weekend time periods

Journal of Pain ◽

10.1016/j.jpain.2012.01.071 ◽

2012 ◽

Vol 13 (4) ◽

pp. S16

Author(s):

R. Chapman ◽

A. Lipman

Keyword(s):

Pain Management ◽

Postoperative Pain ◽

Postoperative Pain Management ◽

Patient Reported ◽

Time Periods

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An Interactive Pain Application (MServ) Improves Postoperative Pain Management

Pain Research and Management ◽

10.1155/2021/8898170 ◽

2021 ◽

Vol 2021 ◽

pp. 1-12

Author(s):

Richard Gordon-Williams ◽

Andreia Trigo ◽

Paul Bassett ◽

Amanda Williams ◽

Stephen Cone ◽

...

Keyword(s):

Pain Management ◽

Postoperative Pain ◽

Nursing Staff ◽

Pain Control ◽

Standard Care ◽

Severe Pain ◽

Postoperative Pain Management ◽

Pain Scale ◽

Opioid Prescription ◽

Patient Reported

Background. Most patients have moderate or severe pain after surgery. Opioids are the cornerstone of treating severe pain after surgery but cause problems when continued long after discharge. We investigated the efficacy of multifunction pain management software (MServ) in improving postoperative pain control and reducing opioid prescription at discharge. Methods. We recruited 234 patients to a prospective cohort study into sequential groups in a nonrandomised manner, one day after major thoracic or urological surgery. Group 1 received standard care (SC, n = 102), group 2 were given a multifunctional device that fed back to the nursing staff alone (DN, n = 66), and group 3 were given the same device that fed back to both the nursing staff and the acute pain team (DNPT, n = 66). Patient-reported pain scores at 24 and 48 hours and patient-reported time in severe pain, medications, and satisfaction were recorded on trial discharge. Findings. Odds of having poor pain control (>1 on 0–4 pain scale) were calculated between standard care (SC) and device groups (DN and DNPT). Patients with a device were significantly less likely to have poor pain control at 24 hours (OR 0.45, 95% CI 0.25, 0.81) and to report time in severe pain at 48 hours (OR 0.62, 95% CI 0.47–0.80). Patients with a device were three times less likely to be prescribed strong opioids on discharge (OR 0.35, 95% CI 0.13 to 0.95). Interpretation. Using an mHealth device designed for pain management, rather than standard care, reduced the incidence of poor pain control in the postoperative period and reduced opioid prescription on discharge from hospital.

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Postoperative Pain Management and Acupuncture: A Case Report of Meniscal Cyst Excision

Acupuncture in Medicine ◽

10.1136/aim.2008.000356 ◽

2009 ◽

Vol 27 (2) ◽

pp. 79-80 ◽

Cited By ~ 3

Author(s):

Nikiforos Galanis ◽

Chara Stavraka ◽

Triantafyllia Boutsiadou ◽

John M Kirkos ◽

George Kapetanos

Keyword(s):

Pain Management ◽

Postoperative Pain ◽

Postoperative Pain Management ◽

Optimal Recovery ◽

Complete Relief ◽

Meniscal Cyst ◽

Cyst Excision ◽

Patient Reported ◽

The Usa ◽

The Uk

We report a case of pain management after a meniscal cyst excision, with the use of electroacupuncture (EA). There are a few reports which indicate that postoperative pain management is prerequisite for the patient's optimal recovery, but surveys in the UK and the USA have identified an unacceptable prevalence of poor pain control after surgery, which might increase the risk of a chronic pain state. The conventional treatment of postoperative pain includes systemic medications such as opioids, non-steroidal anti-inflammatory drugs and other non-opioid agents. In our case, the rehabilitation lasted for 6 months without significant benefit. After that period our patient was treated with EA. By the end of the first EA session the relief of pain was notable and after a course of 10 treatments the patient reported complete relief of the symptoms with no recurrence during a 2 year follow up period. In conclusion, this might indicate that EA could be useful for postoperative pain management.

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Intravenous Acetaminophen for Postoperative Pain Management in Patients Undergoing Living Laparoscopic Living-Donor Nephrectomy

Annals of Pharmacotherapy ◽

10.1177/1060028016669162 ◽

2016 ◽

Vol 51 (1) ◽

pp. 21-26 ◽

Cited By ~ 2

Author(s):

Van Vu ◽

William L. Baker ◽

Elizabeth M. Tencza ◽

Caroline Rochon ◽

Patricia A. Sheiner ◽

...

Keyword(s):

Pain Management ◽

Postoperative Pain ◽

Living Donor ◽

Postoperative Pain Management ◽

Living Donor Nephrectomy ◽

Pain Scores ◽

Opioid Administration ◽

Patient Reported ◽

Average Pain ◽

Control Versus

Background: Postoperative pain is a common complication of laparoscopic living-donor nephrectomies (LLDNs). Objective: To determine whether intravenous (IV) acetaminophen administration post-LLDN influenced length of stay (LOS) when used for pain management. Methods: This single-center, retrospective study compared patients undergoing LLDN who had received IV acetaminophen for pain control versus those who did not between June 1, 2011, and November 30, 2015. Patient LOS, 30-day readmissions, frequency of pain assessments, patient-reported pain scores, and opioid administration were assessed. Results: A total of 90 patients were included in the analysis (IV acetaminophen, n = 48; non-IV acetaminophen, n = 42). Patients who did not receive IV acetaminophen were more often older (48.8 ± 12.1 vs 39.3 ± 12.1 years; P = 0.012) and female (71.4% vs 47.9%; P < 0.001). The average LOS was similar between the 2 groups (median = 3.0; interquartile range = [3, 4] vs 3.5 [3, 4]; P = 0.737). The 30-day readmissions were higher in the IV acetaminophen group (16.7%) compared with the group not receiving IV acetaminophen (2.4%; P = 0.033). After the first postoperative day, the frequencies of pain assessments performed were similar among the 2 groups. There was no difference in average pain scores between the groups at any time after LLDN. Conclusions: Patients receiving IV acetaminophen were found to have no improvements in hospital LOS, average pain score, or opioid requirements compared with patients not receiving IV acetaminophen. Patients who received IV acetaminophen were also found to have a higher 30-day readmission rate.

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Open versus Laparoscopic Surgery: Does the Surgical Technique Influence Pain Outcome? Results from an International Registry

Pain Research and Treatment ◽

10.1155/2016/4087325 ◽

2016 ◽

Vol 2016 ◽

pp. 1-5 ◽

Cited By ~ 3

Author(s):

Renée Allvin ◽

Narinder Rawal ◽

Eva Johanzon ◽

Ragnar Bäckström

Keyword(s):

Pain Management ◽

Postoperative Pain ◽

Surgical Technique ◽

Laparoscopic Group ◽

Postoperative Pain Management ◽

Outcome Data ◽

Open Group ◽

Colonic Surgery ◽

Patient Reported ◽

Pain Outcome

Postoperative pain management relevant for specific surgical procedures is debated. The importance of evaluating pain with consideration given to type of surgery and the patient’s perspective has been emphasized. In this prospective cohort study, we analysed outcome data from 607 patients in the international PAIN OUT registry for assessment and comparison of postoperative pain outcome within the 24 first hours after laparoscopic and open colonic surgery. Patients from the laparoscopic group scored minimum pain at a higher level than the open group (P=0.012). Apart from minimum pain, no other significant differences in patient reported outcomes were observed. Maximum pain scores >3 were reported from 77% (laparoscopic) and 68% (open) patients (mean ≥ 5 in both groups). Pain interference with mobilization was reported by 87–93% of patients. Both groups scored high levels of patient satisfaction. In the open group, a higher frequency of patients received a combination of general and regional anaesthesia, which had an impact of the minimum pain score. Our results from registry data indicate that surgical technique does not influence the quality of postoperative pain management during the first postoperative day if adequate analgesia is given.

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