Postoperative Pain Management and Perceived Patient Outcomes following Endoscopic Pituitary Surgery

2020 ◽  
Author(s):  
Austin T. Hoke ◽  
Madison Malfitano ◽  
Lucas Frickey ◽  
Adam J. Kimple ◽  
Adam M. Zanation ◽  
...  
Author(s):  
Austin Thomas-Kim Hoke ◽  
Madison J Malfitano ◽  
Adam M Zanation ◽  
Brian D Thorp ◽  
Adam J Kimple ◽  
...  

Objectives: Pain management remains a point of emphasis given the ongoing opioid crisis. There are no studies in the literature interrogating opioid prescribing and use following endoscopic pituitary surgery. This study investigate provider prescribing tendency, patient utilization of analgesics, and patient outcomes regarding pain management after endoscopic pituitary surgery. Methods: We identified 100 patients undergoing endoscopic pituitary surgery at one institution from 2016 – 2018 in the electronic medical record (EMR) and state narcotic database to determine postoperative analgesic regimens. A telephone survey was used to characterize postoperative analgesic use and satisfaction with prescribed regimens. Results: 52 different pain control regimens were prescribed to study patients. 93% of study patients were prescribed an opioid postoperatively. The average quantity of opioids prescribed per patient in morphine milligram equivalents (MME) was 625 (equivalent 83 oxycodone 5 mg tablets) with an average MME/day of 59 (equivalent 8 oxycodone 5 mg tablets). Average total MME, MME/day, and pills/tablets per opioid prescription decreased significantly over the study period. 71% of survey respondents who used opioids reported using <25% of their prescription. The majority of prescription narcotic users consumed >50% of their postoperative opioid intake in the first 24-48 hours after discharge. There were no significant differences in pain outcome between opioid users and non-opioid users. Conclusions: Vast heterogeneity exists in narcotic prescribing by providers at our institution following endoscopic pituitary surgery. Narcotic prescribing patterns exceeded most patients’ analgesic needs. Opioid analgesics were not superior to non-opioids regimens in patient-reported pain outcomes in this study population.


2014 ◽  
Vol 4 (1) ◽  
Author(s):  
Maria Frödin ◽  
Margareta Warrén Stomberg

Pain management is an integral challenge in nursing and includes the responsibility of managing patients’ pain, evaluating pain therapy and ensuring the quality of care. The aims of this study were to explore patients’ experiences of pain after lung surgery and evaluate their satisfaction with the postoperative pain management. A descriptive design was used which studied 51 participants undergoing lung surgery. The incidence of moderate postoperative pain varied from 36- 58% among the participants and severe pain from 11-26%, during their hospital stay. Thirty-nine percent had more pain than expected. After three months, 20% experienced moderate pain and 4% experienced severe pain, while after six months, 16% experienced moderate pain. The desired quality of care goal was not fully achieved. We conclude that a large number of patients experienced moderate and severe postoperative pain and more than one third had more pain than expected. However, 88% were satisfied with the pain management. The findings confirm the severity of pain experienced after lung surgery and facilitate the apparent need for the continued improvement of postoperative pain management following this procedure.


Sign in / Sign up

Export Citation Format

Share Document