scholarly journals Determination of moderate-to-severe postoperative pain on the numeric rating scale: a cut-off point analysis applying four different methods

2011 ◽  
Vol 107 (4) ◽  
pp. 619-626 ◽  
Author(s):  
H.J. Gerbershagen ◽  
J. Rothaug ◽  
C.J. Kalkman ◽  
W. Meissner
Keyword(s):  
Postoperative Pain ◽  
Rating Scale ◽  
Numeric Rating Scale ◽  
Point Analysis ◽  
Severe Postoperative Pain ◽  
Numeric Rating

scholarly journals Effectiveness of Ketoprofen Suppositoria as Preemptive Analgesia for Postoperative Pain in Patients Undergoing Elective Surgery with General Anesthesia

2020 ◽  
Vol 2 (1) ◽  
pp. 20
Author(s):  
Lupi Lestari ◽  
Elizeus Hanindito ◽  
Arie Utariani
Keyword(s):  
Pain Management ◽  
Side Effects ◽  
Postoperative Pain ◽  
General Anesthesia ◽  
Rating Scale ◽  
Postoperative Pain Management ◽  
Numeric Rating Scale ◽  
Preemptive Analgesia ◽  
Acute Postoperative Pain ◽  
Numeric Rating

Introduction: Effective postoperative pain management provides improved patient comfort and satisfaction, earlier mobilization, fewer pulmonary and cardiac complications, reduced risk deep vein thrombosis, fast recovery, and reduced cost of care. Preemptive analgesia, initiated before the surgical procedure to prevent pain in the early postoperative period, has the potential to be more effective than a similar analgesic treatment initiated after surgery. As a part of multimodal analgesia, the use of NSAIDs should always be considered for acute postoperative pain management. NSAIDs can be used preoperatively as a part of the preemptive regimen and for postoperative pain control to increase the efficacy of opioids and reduce its side effects. Material and Method: This research was experimental research with a case-control design of the study. The samples separated into two groups, the first group got ketoprofen suppository before the induction, and the second group didn’t get the ketoprofen suppository The intensity of pain measured with the Numeric Rating Scale (NRS) or Wong-Baker Faces Pain Scale was the variable studied at different postoperative times (30 min, 60 min, 120 min, 2-6 hours, 6-12 hours). The total amount of rescue analgesics (fentanyl) and side effects were other variables of this study. Result and Discussion: The result is ketoprofen suppository as preemptive analgesia administrations can reduce postoperative pain. Numeric Rating Scale was significantly lower in the ketoprofen group compared to the control group (p < 0,05) at 30 min, 60 min, 230 min, 2-6 hours, 6-12 hours. The number of postoperative analgesics needed in the recovery room was significant differences among both groups (p < 0,05). Conclusion: Preemptive analgesia in patients who underwent an operation with general anesthesia with ketoprofen suppository was effectively in blocking noxious stimuli and central sensitization, with subsequent prevention of acute postoperative pain.

Procedure-specific Risk Factor Analysis for the Development of Severe Postoperative Pain

2014 ◽  
Vol 120 (5) ◽  
pp. 1237-1245 ◽  
Author(s):  
Hans J. Gerbershagen ◽  
Esther Pogatzki-Zahn ◽  
Sanjay Aduckathil ◽  
Linda M. Peelen ◽  
Teus H. Kappen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Pain ◽  
Postoperative Pain ◽  
Pain Intensity ◽  
Surgical Procedures ◽  
Rating Scale ◽  
Random Effect ◽  
Numeric Rating Scale ◽  
Younger Age ◽  
Severe Postoperative Pain

Abstract Background: Many studies have analyzed risk factors for the development of severe postoperative pain with contradictory results. To date, the association of risk factors with postoperative pain intensity among different surgical procedures has not been studied and compared. Methods: The authors selected precisely defined surgical groups (at least 150 patients each) from prospectively collected perioperative data from 105 German hospitals (2004–2010). The association of age, sex, and preoperative chronic pain intensity with worst postoperative pain intensity was studied with multiple linear and logistic regression analyses. Pooled data of the selected surgeries were studied with random-effect analysis. Results: Thirty surgical procedures with a total number of 22,963 patients were compared. In each surgical procedure, preoperative chronic pain intensity and younger age were associated with higher postoperative pain intensity. A linear decline of postoperative pain with age was found. Females reported more severe pain in 21 of 23 surgeries. Analysis of pooled surgical groups indicated that postoperative pain decreased by 0.28 points (95% CI, 0.26 to 0.31) on the numeric rating scale (0 to 10) per decade age increase and postoperative pain increased by 0.14 points (95% CI, 0.13 to 0.15) for each higher score on the preoperative chronic pain scale. Females reported 0.29 points (95% CI, 0.22 to 0.37) higher pain intensity. Conclusions: Independent of the type and extent of surgery, preoperative chronic pain and younger age were associated with higher postoperative pain. Females consistently reported slightly higher pain scores regardless of the type of surgery. The clinical significance of this small sex difference has to be analyzed in future studies.

Pain after Cardiac Surgery

2006 ◽  
Vol 105 (4) ◽  
pp. 794-800 ◽  
Author(s):  
Pasi Lahtinen ◽  
Hannu Kokki ◽  
Markku Hynynen
Keyword(s):  
Cardiac Surgery ◽  
Postoperative Pain ◽  
Scale Score ◽  
Severe Pain ◽  
Rating Scale ◽  
Artery Bypass ◽  
Numeric Rating Scale ◽  
Persistent Pain ◽  
Numeric Rating Scale Score ◽  
Numeric Rating

Background Persistent chest pain may originate from cardiac surgery. Conflicting results have been reported on the incidence of persistent poststernotomy pain with considerable discrepancies between the retrospective reports and the one prospective study conducted to assess this pain. Therefore, the authors conducted a follow-up survey for the first 12 months after cardiac surgery in 213 patients who had a sternotomy. Methods The authors performed a prospective inquiry of acute and chronic poststernotomy pain both before and after cardiac surgery. Two hundred thirteen coronary artery bypass patients received a questionnaire preoperatively, 4 days postoperatively, and 1, 3, 6, and 12 months postoperatively. All patients were asked about their expectations, their preferences, and the location and intensity of postoperative pain. Results The return rates for the postal questionnaires were 203 (95%) and 186 (87%) after 1 and 12 months, respectively. Patients experienced more pain postoperatively at rest than they had expected to preoperatively. At rest, the worst actual postoperative pain was 6 (0-10), and the worst expected pain as assessed preoperatively was 5 (0-10) (P = 0.013). The worst reported postoperative pain was severe (numeric rating scale score 7-10) in 49% at rest, in 78% during coughing, and in 62% of patients on movement. One year after the operation, 26 patients (14%) reported mild chronic poststernotomy pain at rest, 1 patient (1%) had moderate pain, and 3 patients (2%) had severe pain. Upon movement, persistent pain was even more common: 45 patients (24%) had mild, 5 patients (3%) had moderate, and 7 patients (4%) had severe pain. Patients who experienced moderate to severe acute postoperative pain also reported any chronic poststernotomy pain (numeric rating scale score 1-10) more frequently. Conclusions Although common, the incidence of persistent pain after sternotomy was lower than previously reported. Also, reassuringly, 1 year after surgery this pain was mostly mild in nature both at rest and on movement.

scholarly journals Postoperative Drip-Infusion of Remifentanil Reduces Postoperative Pain—A Retrospective Observative Study

2021 ◽  
Vol 18 (17) ◽  
pp. 9225
Author(s):  
Yi-Hsuan Huang ◽  
Meei-Shyuan Lee ◽  
Yao-Tsung Lin ◽  
Nian-Cih Huang ◽  
Jing Kao ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Adverse Effects ◽  
Rating Scale ◽  
Numeric Rating Scale ◽  
Intravenous Anesthesia ◽  
Anesthetic Care ◽  
Drip Infusion ◽  
Pain Scores ◽  
Unpleasant Experience ◽  
Numeric Rating

Development of remifentanil-induced hyperalgesia (RIH) postoperatively is an unpleasant experience that requires further treatment. This study assessed the effects of gradual withdrawal combined with drip infusion of remifentanil on postoperative pain and the requirement for rescue analgesics. A total of 559 patients receiving total intravenous anesthesia with propofol and remifentanil were enrolled. All patients either underwent gradual withdrawal of remifentanil (GWR) or gradual withdrawal combined with drip infusion (GWDR) with a dose of 1 mcg·kg−1 for 30 min after extubation. The numeric rating scale (NRS) and the requirement of rescue analgesics were assessed. The requirement for rescue analgesics was significantly lower in the GWDR group than in the GWR group (13.2% vs. 35.7%; p < 0.001). At the post-anesthetic care unit (PACU), patients in the GWDR group had a lower NRS pain score (p < 0.001). In addition, in the postoperative 2nd hour, patients in the GWDR group had a significantly lower NRS than the GWR group (beta, −0.31; p = 0.003). No remifentanil-related adverse effects were observed. We found that gradual withdrawal combined with drip infusion of remifentanil required less rescue analgesics and reduced pain scores. The new way of remifentanil administration may be effective to prevent RIH.

Postoperative Pain and Age: A Retrospective Cohort Association Study

2021 ◽  
Author(s):  
Jacqueline F. M. van Dijk ◽  
Ruth Zaslansky ◽  
Regina L. M. van Boekel ◽  
Juanita M. Cheuk-Alam ◽  
Sara J. Baart ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Retrospective Cohort ◽  
Severe Pain ◽  
Rating Scale ◽  
Pain Treatment ◽  
The Elderly ◽  
Numeric Rating Scale ◽  
Opioid Administration ◽  
Patient Reported ◽  
Numeric Rating

Background As the population ages, the number of elderly people undergoing surgery increases. Literature on the incidence and intensity of postoperative pain in the elderly is conflicting. This study examines associations between age and pain-related patient reported outcomes and perioperative pain management in a dataset of surgical patients undergoing four common surgeries: spinal surgery, hip or knee replacement, or laparoscopic cholecystectomy. Based on the authors’ clinical experience, they hypothesize that pain scores are lower in older patients. Methods In this retrospective cohort, study data were collected between 2010 and 2018 as part of the international PAIN OUT program. Patients filled out the International Pain Outcomes Questionnaire on postoperative day 1. Results A total of 11,510 patients from 26 countries, 59% female, with a mean age of 62 yr, underwent one of the aforementioned types of surgery. Large variation was detected within each age group for worst pain, yet for each surgical procedure, mean scores decreased significantly with age (mean Numeric Rating Scale range, 6.3 to 7.3; β = –0.2 per decade; P ≤ 0.001), representing a decrease of 1.3 Numeric Rating Scale points across a lifespan. The interference of pain with activities in bed, sleep, breathing deeply or coughing, nausea, drowsiness, anxiety, helplessness, opioid administration on the ward, and wish for more pain treatment also decreases with age for two or more of the procedures. Across the procedures, patients reported being in severe pain on postoperative day one 26 to 38% of the time, and pain interfered moderately to severely with movement. Conclusions The authors’ findings indicate that postoperative pain decreases with increasing age. The change is, however, small and of questionable clinical significance. Additionally, there are still too many patients, at any age, undergoing common surgeries who suffer from moderate to severe pain, which interferes with function, supporting the need for tailoring care to the individual patient. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New

scholarly journals Pain Intensity on the First Day after Surgery

2013 ◽  
Vol 118 (4) ◽  
pp. 934-944 ◽  
Author(s):  
Hans J. Gerbershagen ◽  
Sanjay Aduckathil ◽  
Albert J. M. van Wijck ◽  
Linda M. Peelen ◽  
Cor J. Kalkman ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Pain Intensity ◽  
Surgical Procedures ◽  
Severe Pain ◽  
Rating Scale ◽  
Pain Treatment ◽  
Numeric Rating Scale ◽  
Treatment Needs ◽  
Pain Scores ◽  
Numeric Rating

Abstract Background: Severe pain after surgery remains a major problem, occurring in 20–40% of patients. Despite numerous published studies, the degree of pain following many types of surgery in everyday clinical practice is unknown. To improve postoperative pain therapy and develop procedure-specific, optimized pain-treatment protocols, types of surgery that may result in severe postoperative pain in everyday practice must first be identified. Methods: This study considered 115,775 patients from 578 surgical wards in 105 German hospitals. A total of 70,764 patients met the inclusion criteria. On the first postoperative day, patients were asked to rate their worst pain intensity since surgery (numeric rating scale, 0–10). All surgical procedures were assigned to 529 well-defined groups. When a group contained fewer than 20 patients, the data were excluded from analysis. Finally, 50,523 patients from 179 surgical groups were compared. Results: The 40 procedures with the highest pain scores (median numeric rating scale, 6–7) included 22 orthopedic/trauma procedures on the extremities. Patients reported high pain scores after many “minor” surgical procedures, including appendectomy, cholecystectomy, hemorrhoidectomy, and tonsillectomy, which ranked among the 25 procedures with highest pain intensities. A number of “major” abdominal surgeries resulted in comparatively low pain scores, often because of sufficient epidural analgesia. Conclusions: Several common minor- to medium-level surgical procedures, including some with laparoscopic approaches, resulted in unexpectedly high levels of postoperative pain. To reduce the number of patients suffering from severe pain, patients undergoing so-called minor surgery should be monitored more closely, and postsurgical pain treatment needs to comply with existing procedure-specific pain-treatment recommendations.

Numeric rating scale: patients' perceptions of its use in postoperative pain assessments

2014 ◽  
Vol 27 (1) ◽  
pp. 41-46 ◽  
Author(s):  
Kerstin Eriksson ◽  
Lotta Wikström ◽  
Kristofer Årestedt ◽  
Bengt Fridlund ◽  
Anders Broström
Keyword(s):  
Postoperative Pain ◽  
Rating Scale ◽  
Numeric Rating Scale ◽  
Numeric Rating
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