scholarly journals Educational Intervention for Effective Postoperative Pain Management in Low Resource Settings: Evidence from Ethiopia

2019 ◽  
Author(s):  
Million Tesfaye Eshete ◽  
Petra I. Baeumler ◽  
Markos Tesfaye ◽  
Yemane Ayele ◽  
Abraham Haileamlak ◽  
...  
Keyword(s):  
Decision Making ◽  
Pain Management ◽  
Postoperative Pain ◽  
Pain Intensity ◽  
Educational Intervention ◽  
Patient Reported Outcomes ◽  
Postoperative Pain Management ◽  
Control Group ◽  
Patient Reported ◽  
The Impact

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.

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

2016 ◽  
Vol 31 ◽  
pp. 27-33 ◽  
Author(s):  
Filippo Sanfilippo ◽  
Caren Conticello ◽  
Cristina Santonocito ◽  
Carmelo Minardi ◽  
Filippo Palermo ◽  
...  
Keyword(s):  
Pain Management ◽  
Postoperative Pain ◽  
Patient Reported Outcomes ◽  
Postoperative Pain Management ◽  
Patient Reported

scholarly journals The impact of medical clowns exposure over postoperative pain and anxiety in children and caregivers: An Israeli experience

2019 ◽  
Vol 11 (3) ◽  
Author(s):  
Nitza Newman ◽  
Slava Kogan ◽  
Moshe Stavsky ◽  
Shay Pintov ◽  
Yotam Lior
Keyword(s):  
Pain Management ◽  
Postoperative Pain ◽  
Therapy Group ◽  
Postoperative Pain Management ◽  
Serum Cortisol ◽  
Pain Reduction ◽  
Parental Distress ◽  
Post Surgery ◽  
Emotional Outcomes ◽  
The Impact

While postoperative pain management was shown to reduce unwanted physiological and emotional outcomes, pediatric postoperative pain management remains suboptimal. Medical-clowns were shown to be beneficial in many medical contexts including reduction of stress, anxiety and pain. This study was set to assess the effectiveness of medical-clowns on pediatric postoperative pain reduction. Children age 4 or above, planned for elective hernia repair surgery were recruited. Children were randomly divided to a control or medicalclown escorted groups. Demographical and clinical data were collected using questionnaires and electronic sheets. Children escorted by clowns reported lower levels of pain upon admittance, discharge and 12-hours post-surgery. Statistically significant reduction of parental distress and significantly higher serum cortisol levels were observed in the clown-therapy group. Although small, our study supports the possibility that preoperative medical-clown therapy might be a cheap, safe and yet beneficial method for postoperative pain reduction.

Regional anaesthesia for postoperative pain management after liver resection

2012 ◽  
Vol 19 (3) ◽  
pp. 126-129
Author(s):  
Darius Trepenaitis ◽  
Tadas Česnaitis ◽  
Andrius Macas
Keyword(s):  
Pain Management ◽  
Liver Resection ◽  
Postoperative Pain ◽  
Adverse Effects ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Postoperative Pain Management ◽  
Control Group ◽  
Wound Infiltration ◽  
Adequate Treatment

Background. Pain is the most common complication in the postoperative period. If adequate treatment is not taken, it can transform to chronic pain. Postoperative pain brings a lot of social, psychological and financial problems for patients and their families. Materials and methods. This prospective study included 30 patients after laparatomic liver resection operation. Patients were randomly assign­ ed to Infiltrated or Control groups. An infiltration of 40 ml levobupivacaine 0.25% solution to the operation cut edges was performed to the Infiltrated group. The pain was evaluated using the numerical rating scale after 2, 5, 12, 24, 48 hours and 1 month after the operation. Our aim was to determine the effect of local anesthesia in the operation wound. The total usage of morphine and any side effects were registered. Results. A statistically significant reduction in pain was observed in the Infiltrated group in all evaluation periods. Opioids usage was higher in the Control group almost by 4 times and adverse effects were 9 to 1 compared to the Infiltrated group. Conclusions. Surgical wound infiltration with local anesthetic for postoperative pain management after liver resection operations has a positive effect on postoperative pain reduction and leads to lesser usage of opioid analgetics. As a result, there is a less chance of opioids induced adverse effects.

scholarly journals An Interactive Pain Application (MServ) Improves Postoperative Pain Management

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.

Less is more: Postoperative pain management using restrictive opioid protocols in all surgical services in a comprehensive cancer center.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 103-103
Author(s):  
Jason Ricciuti ◽  
Steven Gallo ◽  
Deanna Argentieri ◽  
Paul Visco ◽  
Kristopher Attwood ◽  
...  
Keyword(s):  
Pain Management ◽  
Postoperative Pain ◽  
Patient Experience ◽  
Postoperative Pain Management ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Control Group ◽  
Prescription Database ◽  
Opioid Prescription ◽  
Surgical Services

103 Background: Opioids are routinely given for postoperative pain management with limited evidence on the amount needed to be dispensed. Prescribed opioids increase the risk of chronic use, abuse, and diversion, which contribute to the opioid epidemic. We sought to demonstrate that postsurgical acute pain can be effectively managed across different surgical specialties with a markedly reduced number of opioids. Methods: A prospective case-control study of restrictive opioid prescription protocol (ROPP) was implemented in all surgical services from February 2019 through July 2019 at a tertiary comprehensive cancer center for all patients undergoing a surgery for which opioids would be routinely prescribed at discharge (n = 2,015). Data from surgeries performed by the same services from August 2018 through January 2019 were used for comparison (n = 2,051). At discharge, patients did not routinely receive opioids unless they had a maximally invasive procedure or if they required multiple doses of opioids during hospitalization (maximum 3-day supply). Compliance with the protocol was tracked by pharmacists daily. Patient demographics and surgical details were collected. State-run opioid prescription database was used to determine the number of opioids prescribed to all surgical patients within a 120-day surgical window. Validated patient satisfaction surveys were used at postoperative visits to assess patient experience. Results: After implementation of the ROPP, 45% less opioids were prescribed after surgery for all participating patients (323,674 morphine milligram equivalents (MME) vs 179,458 MME, p < 0.001). The majority of services complied with the ROPP in more than 95% of cases. There was no difference in postsurgical pain intensity between cohorts. Patients in the ROPP cohort had less refill requests compared to the control group (20.9% vs 17.9%, p value = 0.016). Surveys were completed by 338 patients in the control group (16.5%) and 360 in the ROPP group (17.9%). There was no significant difference in patient reported satisfaction with postoperative pain control or on the impact of pain on daily activities between the cohorts. Conclusions: Implementation of a ROPP by multiple surgical services at a tertiary cancer center was feasible and resulted in substantial decrease in the number of opioids prescribed while not compromising patient experience. Patients did not require more prescription refills despite being provided no opioids or a limited supply. This study provides evidence to support reducing the number of opioids routinely prescribed after surgery.[Table: see text]

Postoperative pain management with tramadol after craniotomy: evaluation and cost analysis

2010 ◽  
Vol 112 (2) ◽  
pp. 268-272 ◽  
Author(s):  
Scott Y. Rahimi ◽  
Cargill H. Alleyne ◽  
Eric Vernier ◽  
Mark R. Witcher ◽  
John R. Vender
Keyword(s):  
Pain Management ◽  
Postoperative Pain ◽  
Management Strategies ◽  
Length Of Hospital Stay ◽  
Postoperative Pain Management ◽  
Control Group ◽  
Pain Scores ◽  
Pain Medications ◽  
Hospitalization Costs ◽  
Hospital Stays

Object Patients undergoing craniotomies have traditionally received opiates with acetaminophen for the management of their postoperative pain. The use of narcotic pain medications can be costly, decrease rates of early postoperative ambulation, lengthen hospital stays, and alter a patient's neurological examination. The use of alternative pain medications such as tramadol may benefit patients by resolving many of these issues. Methods The authors conducted a randomized, blinded prospective study to evaluate the efficacy of alternative pain management strategies for patients following craniotomies. Fifty patients were randomly assigned either to a control group who received narcotics and acetaminophen alone or an experimental group who received tramadol in addition to narcotic pain medications (25 patients assigned to each group). Results The control group was noted to have statistically significant higher visual analog scale pain scores, an increased length of hospital stay, and increased narcotic use compared with the tramadol group. The narcotics and acetaminophen group also had increased hospitalization costs when compared with the tramadol group. Conclusions The use of scheduled atypical analgesics such as tramadol in addition to narcotics with acetaminophen for the management of postoperative pain after craniotomy may provide better pain control, decrease the side effects associated with narcotic pain medications, encourage earlier postoperative ambulation, and reduce total hospitalization costs.

Impact of Pharmacist Intervention on Medication Adherence and Patient-Reported Outcomes among Depressed Patients in a Private Psychiatric Hospital of Nepal: a randomised controlled trial

2020 ◽  
pp. 001857872097046
Author(s):  
Nirmal Raj Marasine ◽  
Sabina Sankhi ◽  
Rajendra Lamichhane
Keyword(s):  
Medication Adherence ◽  
Psychiatric Hospital ◽  
Patient Reported Outcomes ◽  
Intervention Group ◽  
Control Group ◽  
Pharmaceutical Service ◽  
Patient Reported ◽  
Service Intervention ◽  
Severity Of Depression ◽  
The Impact

Aim: We aimed to evaluate the impact of pharmaceutical service intervention on medication adherence and patient-reported outcomes among patients diagnosed with depression in a private psychiatric hospital in Nepal. Methods: A single-center, open trial with a parallel design was conducted among 18 to 65 years aged patients, diagnosed with depression and under antidepressant medication(s) for ≥2 months. Patients were randomised into either the intervention or control group. The control group (n = 98) received the usual care, while the intervention group (n = 98) received a pharmaceutical service intervention. The two groups were compared using the Mann-Whitney U test, independent t-test, or chi-square test at 2 and 4 months for changes in medication adherence and patient-reported [severity of depression and health-related quality of life (HRQoL)] outcomes. Results: One hundred ninety adult patients were enrolled in the study. At baseline, there were no significant differences in any of the outcome measures between the intervention and control groups. At 2 and 4 months, the intervention group had a significant improvement only in medication adherence ( P < .001) compared with the control group [MGL score: 1 (2) vs 2 (2) and 1 (1) vs 2 (1), P < .001, respectively]. Conclusion: Our study suggests that a brief pharmaceutical service intervention in the hospital setting can have a significant impact on patients’ adherence to antidepressants but does not improve their severity of depression and HRQoL.

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