Clegg-Lamptey Jna, Hodasi Wm
Department of Surgery, University of Ghana Medical School, P O Box 4236, Accra, Ghana.
Ghana Med J. 2005 Jun;39(2):63-7. doi: 10.4314/gmj.v39i2.35984.
SummaryThere is the need to adequately inform patients about their disease, treatment options, surgery and post-operative complications. Adequate pain relief after surgery leads to less morbidity. Two important aspects of surgical practice are being addressed in this paper, the need for informed consent and post operative pain relief.A questionnaire survey was carried out in 100 patients on the four general surgical wards of the Korle Bu Teaching Hospital, just before they were discharged from hospital. They were asked what they knew or had been informed about their diagnosis, operation and complications of surgery. On pain relief, patients were asked about their experiences on the first post-operative day and what relief they had from analgesics.Twenty four did not know the diagnosis and 36 were not told what operation they were going to have before surgery. Although 75 were eventually told what operation they had, only 64 said they knew the operation. Sixty eight did not know what to expect after surgery; 87 did not know about possible complications. On the first post-operative day there was significant pain (scores 4 and 5) felt by 24 patients at rest and 46 on movement. The most frequently prescribed analgesic was pethidine.Patient information in General surgery at the Korle Bu Teaching Hospital is unsatisfactory. Post-operative analgesia is also poor. There is the need for surgeons to either train doctors to administer consent or administer it themselves. Anaesthetists should assume a leading role in managing post-operative pain.
摘要
有必要让患者充分了解其疾病、治疗选择、手术及术后并发症。术后充分的疼痛缓解可降低发病率。本文探讨了外科手术实践中的两个重要方面,即知情同意的必要性和术后疼痛缓解。
在科勒布教学医院的四个普通外科病房对100名即将出院的患者进行了问卷调查。询问他们对自己的诊断、手术及手术并发症了解多少或被告知多少。关于疼痛缓解,询问了患者术后第一天的经历以及他们从镇痛药中获得了何种缓解。
24人不知道诊断结果,36人在手术前未被告知要进行何种手术。尽管最终有75人被告知做了什么手术,但只有64人表示他们知道手术内容。68人不知道术后会怎样;87人不知道可能的并发症。术后第一天,24名患者静息时感到剧痛(疼痛评分4分和5分),46名患者活动时感到剧痛。最常开具的镇痛药是哌替啶。
科勒布教学医院普通外科的患者信息情况不尽人意。术后镇痛效果也很差。外科医生需要培训医生进行知情同意告知或自己进行告知。麻醉医生应在术后疼痛管理中发挥主导作用。