Postoperative Pain Management and the Incidence of Ipsilateral Shoulder Pain After Thoracic Surgery at an Australian Tertiary-Care Hospital: A Prospective Audit

Background. Pain is the subjective feeling of an individual, which affects the overall recovery of patients after cardiac surgery. Postoperative pain is the most inadequately managed symptom of cardiac surgery. Subsequently, there are many factors that can either hinder or facilitate pain management, including patients' beliefs, cultural values, physiological features, hospital policies, and healthcare providers' knowledge and beliefs. The purpose of this research was to identify factors associated with postoperative pain and its management, after cardiac surgery, among patients in a tertiary care hospital in Karachi, Pakistan. Methods. Quantitative correlational study design was employed to attain the study purpose. Data were collected from 136 adult cardiac surgery patients admitted in the Cardiothoracic Surgery (CTS) Department, of tertiary care hospital. A self-developed questionnaire tool was used to gather information from patients. Data was then analyzed on SPSS version 19. Mann-Whitney U, Kruskal Wallis, and Spearman tests were applied to find the associations between the pain levels and of the independent variables. Results. The mean pain scores of the first, second, and third postoperative days were found to be 2.98, 2.96, and 2.98, respectively. The findings also showed that BMI and the types of surgery were significantly associated with postoperative pain. Patients' beliefs regarding drug dependency, fear of adverse effects, and postoperative physical activities were also associated with pain. Furthermore, the nurses’ education level and reluctance in medication administration due to fear of adverse effects were found to be significant too. Conclusion. The study identified some of the important factors that were associated with postoperative pain. The results suggest the need for the enhancement of patients' education on drug dependency, adverse effects, and physical activity, before cardiac surgery. The nurses should be educated on pain management keeping the patients’ culture and other perceptions of pain in mind.

Download Full-text

01 / Postoperative pain management in thoracic surgery: Paravertebral block versus thoracic epidural.

10.26226/morressier.5aeb0aca07b0d6001a79a7ee ◽

2018 ◽

Author(s):

Manuel Granell Gil

Keyword(s):

Pain Management ◽

Postoperative Pain ◽

Thoracic Surgery ◽

Postoperative Pain Management ◽

Paravertebral Block ◽

Thoracic Epidural

Download Full-text

Assessment of pain management intervention for treatment of long bone fractures in tertiary care hospital

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20194209 ◽

2019 ◽

Vol 6 (5) ◽

pp. 1544

Author(s):

Elizabeth C. Sada ◽

Firdaus Bhot ◽

Rohit Kanishetty

Keyword(s):

Pain Management ◽

Lower Limb ◽

Initial Treatment ◽

Personal Experience ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Long Bone ◽

Study Patient ◽

Care Hospital ◽

Management Intervention

Background: Musculoskeletal trauma represents a considerable global health burden. Pain is a complex, subjective personal experience. The assessment of pain is the essential perquisite for successful pain management. It is useful to decide the plan of initial treatment but also to reassess the degree of success. So the purpose of the study was to do assessment of pain management intervention, post-op analgesics for treatment of long bone fractures.Methods: All adult patients (more than IS years) reporting to Emergency Medicine Department of a tertiary care hospital with long hone fractures of lower limb were included in the study. Patient pain management was assessed by visual analogue score (VAS). Pain is a complex, subjective personal experience. The assessment of pain is the essential perquisite for successful pain management. It is useful to decide the plan of initial treatment but also to reassess the degree of success. The entire data is statistically analyzed using SPSS software. p-values less than 0.05 are considered to be statistically significant.Results: 74 cases got operated, 64 cases (86.5.0%) did not have any intra-op complications and 10 cases (13.50%) had intra-op complications .Postoperative analgesia the 74 cases operated was as follows: 17 cases (23.0%) epidural anaesthesia 41 Cases (55.4%) had epidural + intravenous analgesics. Recent was managed with 1.V, analgesics alone; 12 cases (16.20%) had tramadol, 2 cases (2.7%) received paracetamol and 2 cases (2.7%) had dynaper for post-operative analgesia.Conclusion: Adequate pain management on arrival in the Emergency Department is an important aspect in patient care and is not at all difficult to achieve. Femoral nerve block in Proximal lower limb fractures is very effective and easy to perform.

Download Full-text