Sharma Suresh K, Thakur Kalpana, Mudgal Shiv K, Payal Yashwant S
College of Nursing, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.
Department of Anaesthesiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.
Indian J Anaesth. 2020 May;64(5):403-408. doi: 10.4103/ija.IJA_33_20. Epub 2020 May 1.
There is a paucity of regional data on acute postoperative pain. The present study was conducted with an aim to assess the acute postoperative pain experiences, its interference with ADLs, emotions, sleep, IPR and satisfaction with pain management among patients who had undergone elective surgeries.
In this observational study, 200 postoperative adult patients; who had undergone elective surgery were interviewed using American Pain Society's Patient Outcome and Satisfaction Survey Questionnaire. Pain perception and interference of pain with ADLs, emotions, sleep, and IPR was measured on 0-10 numerical scale and satisfaction on 6 point Likert scale, i.e., very satisfied to very dissatisfied.
There was high incidence (82.5%) of acute postoperative pain experience and mean score for worst episodes of pain was significantly high, i.e., 7.6 ± 1.5, which had significant interference with ADLs (5.6 ± 2.1), sleep (3.6 ± 1.7), and emotions (3.6 ± 1.6). Majority of patients reported that pain was assessed only once (17%) or twice (48.5%) in each shift. Despite of poor pain control, a large number of patients were satisfied with overall pain treatment (69%), and response of physicians (81%) and nurses (62%) for their pain complaints. Acute pain score was directly associated with the duration of postoperative hospital stay ( = 0.001).
Acute postoperative pain was inadequately assessed and undertreated but still a large number of participants were satisfied with acute postoperative pain management probably because patients expects that pain is inevitable after surgery. Postoperative pain had significant interference with ADLs, emotions and sleep of patients, which may affect postoperative comfort and recovery.
关于急性术后疼痛的区域数据匮乏。本研究旨在评估择期手术患者的急性术后疼痛体验、其对日常生活活动(ADLs)、情绪、睡眠、疼痛强度评分(IPR)的干扰以及对疼痛管理的满意度。
在这项观察性研究中,使用美国疼痛协会的患者结局与满意度调查问卷对200名接受择期手术的成年术后患者进行了访谈。疼痛感知以及疼痛对ADLs、情绪、睡眠和IPR的干扰采用0至10的数字评分量表进行测量,满意度采用6点李克特量表进行测量,即从非常满意到非常不满意。
急性术后疼痛体验的发生率很高(82.5%),最严重疼痛发作的平均评分显著较高,即7.6±1.5,这对ADLs(5.6±2.1)、睡眠(3.6±1.7)和情绪(3.6±1.6)有显著干扰。大多数患者报告说,每班疼痛仅评估一次(17%)或两次(48.5%)。尽管疼痛控制不佳,但大量患者对整体疼痛治疗(69%)、医生(81%)和护士(62%)对其疼痛投诉的反应感到满意。急性疼痛评分与术后住院时间直接相关(=0.001)。
急性术后疼痛评估不足且治疗不充分,但仍有大量参与者对急性术后疼痛管理感到满意,可能是因为患者认为术后疼痛不可避免。术后疼痛对患者的ADLs、情绪和睡眠有显著干扰,这可能会影响术后舒适度和恢复。