scholarly journals Adherence Level Of Medical Personnel In Implementing 2019 Postoperative Pain Management Guidelines

2021 ◽  
Vol 14 (02) ◽  
pp. 117-127
Author(s):  
Nasrulloh Nasrulloh ◽  
Hamzah Hamzah ◽  
Arie Utariani ◽  
Dedi Susila
Keyword(s):  
Pain Management ◽  
Postoperative Pain ◽  
Severe Pain ◽  
Postoperative Pain Management ◽  
Medical Personnel ◽  
Multimodal Analgesia ◽  
Systematic Evaluation ◽  
Moderate Pain ◽  
Management Guidelines ◽  
Mild Pain

Introduction: Inadequate pain management may increase the risk of complications and postoperative chronic pain. Postoperative Pain Management Guidelines of The Anesthesiology and Reanimation Department, Faculty of Medicine Universitas Airlangga/ Dr. Soetomo Hospital Surabaya were arranged in 2019. Purposes: This study aim is to analyze the medical personnel’s adherence in implementing postoperative pain management guidelines. Methods: This is descriptive observational study with retrospective design. Total sampling was carried out on the medical records of patients who underwent elective surgery and received postoperative acute pain management during March-May 2020. Results: A total of 349 patients, most of the pain intensity was moderate (62.8%). The medical personnel adherence with postoperative pain management guidelines was 88.0%. The overall use of multimodal analgesia was 61.0%. Adherence to guidelines on pain category was mostly good adherence: 99.1% in mild pain, 82.6% in moderate pain, and 81.2% in severe pain. The use of multimodal analgesia was found in 12.3% mild pain; 83.6% moderate pain, and 100% severe pain patients. Conclusion: Most of the medical personnel have adhered to the postoperative pain management guideline, and widely-used multimodal analgesia. Systematic evaluation of guidelines implementation, patient satisfaction, and outcomes are needed.

scholarly journals Pain management after lung surgery

2014 ◽  
Vol 4 (1) ◽  
Author(s):  
Maria Frödin ◽  
Margareta Warrén Stomberg
Keyword(s):  
Quality Of Care ◽  
Pain Management ◽  
Postoperative Pain ◽  
Severe Pain ◽  
Postoperative Pain Management ◽  
Lung Surgery ◽  
Moderate Pain ◽  
Number Of Patients ◽  
Severe Postoperative Pain

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.

scholarly journals The efficacy of pre-emptive analgesia on pain management in total knee arthroplasty: a mini-review

Arthroplasty ◽  
2019 ◽  
Vol 1 (1) ◽  
Author(s):  
Jianda Xu ◽  
Huan Li ◽  
Chong Zheng ◽  
Bin Wang ◽  
Pengfei Shen ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Pain Management ◽  
Postoperative Pain ◽  
Knee Arthroplasty ◽  
Physiological Mechanism ◽  
Cost Effective ◽  
Postoperative Pain Management ◽  
Multimodal Analgesia ◽  
Total Knee ◽  
End Stage

Abstract Total knee arthroplasty (TKA) is considered a cost-effective and efficacious treatment for patients with end-stage knee arthritis. Meanwhile, TKA has been regarded as one of the most painful orthopaedic surgeries. Pain control after TKA remains a challenging task. Many analgesic innovations are used to reduce the level of pain, but none has been proven to be the optimum choice till now. Multimodal analgesia incorporates the use of analgesic adjuncts with different mechanisms of action to enhance postoperative pain management. This approach is a preferable choice in relieving postoperative pain with minimum side effects. This paper aims to review pre-emptive analgesia for pain management in TKA. We reviewed the application of pre-emptive analgesia, its physiological mechanism, and the techniques.

scholarly journals Post-operative pain management modalities employed in clinical trials for adult patients in LMIC; a systematic review

2020 ◽  
Author(s):  
Gauhar Afshan ◽  
Robyna Irshad Khan ◽  
Aliya Ahmed ◽  
Ali Sarfraz Siddiqui ◽  
Azhar Rehman ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Pain Management ◽  
Postoperative Pain ◽  
Postoperative Pain Management ◽  
Multimodal Analgesia ◽  
Adult Patients ◽  
Cochrane Library ◽  
Regional Analgesia ◽  
Post Operative Pain

Abstract Background: Unrelieved postoperative pain afflicts millions each year in low and middle income countries (LMIC). Despite substantial advances in the study of pain, this area remains neglected. Current systematic review was designed to ascertain the types of clinical trials conducted in LMIC on postoperative pain management modalities over the last decade. Methods: A comprehensive search was performed in June 2019 on PubMed, Cochrane Library, CINAHL Plus, and Web of Science databases to identify relevant trials on the management of postoperative pain in LMIC. Out of 1450 RCTs, 108 studies were reviewed for quality evidence using structured form of critical appraisal skill program. Total of 51 clinical trials were included after applying inclusion/exclusion criteria. Results:Results are charted according to the type of surgery. Eleven trials on laparoscopic cholecystectomy used multimodal analgesia including some form of regional analgesia. Different analgesic modalities were studied in 4 trials on thoracotomy, but none used multimodal approach. In 11 trials on laparotomy, multimodal analgesia was employed along with the studied modalities. In 2 trials on hysterectomy, preemptive pregabalin or gabapentin were used for reduction in rescue analgesia. In 13 trials on breast surgical procedures and 10 on orthopaedic surgery, multimodal analgesia was used with some form of regional analgesia. Conclusion: We found that over the past 10 years, clinical trials for postoperative pain modalities have evolved in LMIC according to the current postoperative pain management guidelines i.e. multi-modal approach with some form of regional analgesia. The current review shows that clinical trials were conducted using multimodal analgesia including but not limited to some form of regional analgesia for postoperative pain in LMIC however this research snapshot (of only three countries) may not exactly reflect the clinical practices in all 47 countries. Post Operative Pain Management Modalities Employed in Clinical Trials for Adult Patients in LMIC; A Systematic Review

scholarly journals Assessment of quality of care in acute postoperative pain management

2009 ◽  
Vol 66 (2) ◽  
pp. 156-162 ◽  
Author(s):  
Dragana Milutinovic ◽  
Verica Milovanovic ◽  
Miroslava Pjevic ◽  
Mirjana Martinov-Cvejin ◽  
Tomislav Cigic
Keyword(s):  
Pain Management ◽  
Postoperative Pain ◽  
Nursing Care ◽  
Severe Pain ◽  
Postoperative Pain Management ◽  
Care Quality ◽  
Acute Postoperative Pain ◽  
Nursing Care Quality ◽  
The Difference

Background/Aim. Managing of acute postoperative pain should be of great interest for all hospital institutions, as one of the key components of patients satisfaction, which indicates quality, as well as the outcome of treatment. The aim of this study was to assess the quality of nursing care in managing acute postoperative pain and to establish factors which influence patients assessment of the same. Method. The investigation was conducted on the sample of 135 patients hospitalized in surgical clinics of the Clinical Centre of Vojvodina in Novi Sad in the form of cross-sectional study, by interviewing patients during the second postoperative day and collecting sociodemographic variables, type of surgical procedure and applied analgesic therapy which were taken from their medical documentation. The modified questionnaire of the Strategic and Clinical Quality Indicators in Postoperative Pain Management (SCQIPP) was used as the instrument of the investigation. The data were processed with suitable mathematical statistics methods such as multivariate analyses of variance (MANOVA), discriminative and other parametric procedures and methods. Roy's test, Pearson's coefficient contingency (?), multiple correlation coefficient (R) were conducted amongst other invariant procedures. Results. The mean score for the individual items of SCQIPP questionnaire was between 2.0 and 4.7 (scale range 1-5) and the percentage of patients answers 'strongly agree' ranged from 4.4 to 77%. The smallest number of positive answers were given by the patients for the item 'In order to assess pain intensity, some of the staff asked me at least once in the morning, in the afternoon and in the evening to show the number from 0-10'. Most of the patients (57%) evaluated severe pain during the previous 24 hours, as moderate pain, which represents significantly greater number of patients which complain of severe pain and mild pain (p < 0.001). The analysis of patients evaluation (MANOVA p < 0.05 and discriminative p < 0.05) indicates the existence of significant difference between the assessment of nursing care quality in managing acute postoperative pain as regards to clinics as the place for pain management, patient's sex and his expectations. Evaluation from 'communication' subscale gives the greatest contribution (24.9%) to the difference between the observed clinics, and the greatest contribution (25.7%) to the difference in evaluation of nursing care quality as regards to patients' sex has the evaluations from 'procedure' subscale. Conclusion. The results of this study show a useful evidence and identify aspects of nursing care in postoperative management of acute pain which are still to be improved. According to the patients' answers the priority should be given to a regular assessment of the intensity of postoperative pain and evaluation of the effects of analgesic therapy.

scholarly journals Post-operative pain management modalities employed in clinical trials for adult patients in LMIC: a systematic review

2020 ◽  
Author(s):  
Gauhar Afshan ◽  
Robyna Irshad Khan ◽  
Aliya Ahmed ◽  
Ali Sarfraz Siddiqui ◽  
Azhar Rehman ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Pain Management ◽  
Postoperative Pain ◽  
Postoperative Pain Management ◽  
Multimodal Analgesia ◽  
Cochrane Library ◽  
Clinical Practices ◽  
Regional Analgesia ◽  
Rescue Analgesia

Abstract Background: Unrelieved postoperative pain afflicts millions each year in low and middle income countries (LMIC). Despite substantial advances in the study of pain, this area remains neglected. Current systematic review was designed to ascertain the types of clinical trials conducted in LMIC on postoperative pain management modalities over the last decade. Methods: A comprehensive search was performed in June 2019 on PubMed, Cochrane Library, CINAHL Plus, and Web of Science databases to identify relevant trials on the management of postoperative pain in LMIC. Out of 1450 RCTs, 108 studies were reviewed for quality evidence using structured form of critical appraisal skill program. Total of 51 clinical trials were included after applying inclusion/exclusion criteria. Results: Results are charted according to the type of surgery. Eleven trials on laparoscopic cholecystectomy used multimodal analgesia including some form of regional analgesia. Different analgesic modalities were studied in 4 trials on thoracotomy, but none used multimodal approach. In 11 trials on laparotomy, multimodal analgesia was employed along with the studied modalities. In 2 trials on hysterectomy, preemptive pregabalin or gabapentin were used for reduction in rescue analgesia. In 13 trials on breast surgical procedures and 10 on orthopaedic surgery, multimodal analgesia was used with some form of regional analgesia. Conclusion: We found that over the past 10 years, clinical trials for postoperative pain modalities have evolved in LMIC according to the current postoperative pain management guidelines i.e. multi-modal approach with some form of regional analgesia. The current review shows that clinical trials were conducted using multimodal analgesia including but not limited to some form of regional analgesia for postoperative pain in LMIC however this research snapshot (of only three countries) may not exactly reflect the clinical practices in all 47 countries.

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.

scholarly journals Perception and Attitudes of Medical Students Regarding Postoperative Pain Management

2021 ◽  
Author(s):  
Fatema Johora ◽  
Asma Akter Abbasy ◽  
Fatiha Tasmin Jeenia ◽  
Ferdaush Ahmed Sojib ◽  
Mohsena Aktar ◽  
...  
Keyword(s):  
Pain Management ◽  
Medical Students ◽  
Postoperative Pain ◽  
Essential Element ◽  
Postoperative Pain Management ◽  
Multimodal Analgesia ◽  
Treatment Modalities ◽  
Early Recovery ◽  
Medical College ◽  
Medical Colleges

Background: Postoperative pain remains a challenging problem, which requires a dynamic approach using a variety of treatment modalities to obtain an optimal outcome with respect to enhancing patient comfort and facilitating the recovery process. Multimodal analgesia signifies an increasingly popular approach to prevent postoperative pain. The approach includes administering a combination of opioid and nonopioid analgesics that act at different sites within the central and peripheral nervous systems in an effort to improve pain control while eliminating opioid-related adverse effects. Materials and Methods: To understand the perception and attitude of 4th year medical students, a structured questionnaire survey was done among six different medical colleges including government (Armed Forces Medical College, Cumilla Medical College and Colonel Malek Medical College, Manikganj) and non-government medical colleges (Army Medical College Bogura, Brahmanbaria Medical College and Chattogram International Medical College) of Bangladesh in October 2019. Total 340 students participated in the study. Result: Among the 340 students, almost 336 (98.2%) students were agreed that postoperative pain management is an essential element of patient care. Only 4 (1.18%) respondents disagreed. On the other hand, regarding its influence on early recovery and reduction of hospital staying, 311 (91.47%) respondents agreed and 29 (8.53%) respondents were found as disagreed. Regarding the issue of opioid commonly induced respiratory depression, 257 (75.59%) respondents thought it is a common adverse event and 81 (23.82%) respondents disagreed. 206 (60.59%) respondents did not agree that opioid always produce addiction or tolerance and 134 (39.71%) respondents disagreed with the same issue. 294 (86) respondents agreed that multimodal analgesia increases patients cost and 46 (14%) disagreed. 249 (74%) students agreed that regional techniques are useful for postoperative pain management and 89 (26%) respondents disagreed. Conclusion: Adequate post-operative pain management knowledge is necessary to reduce post-operative complications.

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