Section of Dermatology, Virginia Tech Carilion School of Medicine, Roanoke, Virginia.
Department of Health Analytics, Carilion Clinic, Roanoke, Virginia.
Dermatol Surg. 2021 Feb 1;47(2):170-173. doi: 10.1097/DSS.0000000000002465.
Little is known about dermatologists' perceptions of postoperative pain and how those perceptions correlate with patient-reported pain and opioid prescribing.
To determine dermatologists' accuracy in predicting postoperative pain compared with patient-reported pain and how physicians' perceptions affect opioid prescribing practices.
A prospective observational study in which patients undergoing Mohs surgery rated pain on the Numerical Rating Scale (0-10). Using the same scale, the physician predicted how much pain the patient would experience postoperatively on the evening of surgery. All analgesic medications taken in postoperative period were recorded.
A total of 316 patients completed the study (70% completion rate). Physician predictions were correlated with patient-reported pain (p < .001; r = 0.29) and were within 2 points of patient-reported pain in 70% of cases. When physicians overestimated patient-reported by ≥3 points, they were not more likely to prescribe opioids (p = .8094). Physicians predicted higher pain for patients who were prescribed opioids (p = .0002).
Dermatologists were fairly accurate at predicting postoperative pain. Dermatologists were not more likely to prescribe opioids when pain was overpredicted.
对于皮肤科医生对术后疼痛的看法，以及这些看法与患者报告的疼痛和阿片类药物处方之间的相关性，我们知之甚少。
旨在确定皮肤科医生预测术后疼痛的准确性与患者报告的疼痛相比如何，以及医生的看法如何影响阿片类药物的处方实践。
一项前瞻性观察性研究，其中接受 Mohs 手术的患者使用数字评分量表（0-10）对疼痛进行评分。使用相同的量表，医生预测患者在手术当晚术后会经历多少疼痛。记录了术后期间服用的所有镇痛药物。
共有 316 名患者完成了这项研究（完成率为 70%）。医生的预测与患者报告的疼痛相关（p <.001；r = 0.29），并且在 70%的情况下，医生的预测与患者报告的疼痛相差 2 分以内。当医生高估患者报告的疼痛≥3 分时，他们不太可能开阿片类药物（p =.8094）。医生预测开阿片类药物的患者疼痛更高（p =.0002）。
皮肤科医生在预测术后疼痛方面相当准确。当疼痛被高估时，皮肤科医生不太可能开阿片类药物。
