McKay William, Lee Danyela, Masu Adolphe, Thakore Shefali, Tuyishime Eugene, Niyitegeka Joseph, Ruhato Paulin, Twagirumugabe Theogene, O'Brien Jennifer
Department of Anesthesiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
Department of Anesthesiology, Critical Care and Emergency Medicine, University of Rwanda, Kigali, Rwanda.
Can J Pain. 2019 Oct 28;3(1):190-199. doi: 10.1080/24740527.2019.1673158. eCollection 2019.
: Postoperative pain management (POPM) appeared to be weak in Rwanda. : The aim of this study was to compare POPM measures in a teaching hospital between 2013 and 2017. : A two-phase observational study in 2013 and 2017. was conducted. Participants were recruited prior to major surgery and followed for two postoperative days. A numerical rating scale (0-10) was administered to all participants in both years, and the International Pain Outcomes questionnaire was administered in 2017. Recruitment, consent, and data collection were performed in participants' preferred language. : One hundred adult participants undergoing major general, gynecologic, orthopedic, or urologic surgery were recruited in 2013 and 83 were recruited in 2017. Fourteen percent of participants in 2013 and 46% in 2017 scored their worst pain as severe (>6; < 0.001). This was despite improved preoperative recognition of patients at high risk for severe postoperative pain (those with chronic pain or preoperative pain); 27% and 0% of these patients were not documented in 2013 and 2017, respectively ( = 0.006). Other measures of improved planning included "any preoperative discussion of POPM" ( < 0.001) and "discussion of POPM options" ( = 0.002). Preemptive analgesia use increased (3% of participants in 2013 and 54% in 2017; < 0.001). Incidence of participants having no postoperative analgesic at all decreased from 25% in 2013 to 5% in 2017 ( < 0.001). : Though severe postoperative pain incidence did not improve from 2013 to 2017, POPM improved by a number of measures. These changes may be attributed to pain research conducted there having raised awareness.
卢旺达的术后疼痛管理（POPM）似乎较为薄弱。本研究旨在比较2013年至2017年一家教学医院的POPM措施。于2013年和2017年进行了一项两阶段观察性研究。参与者在接受大手术前被招募，并在术后随访两天。在这两年中，对所有参与者都使用了数字评分量表（0 - 10），2017年还使用了国际疼痛结果问卷。招募、同意和数据收集均以参与者偏好的语言进行。2013年招募了100名接受普通外科、妇科、骨科或泌尿外科大手术的成年参与者，2017年招募了83名。2013年14%的参与者和2017年46%的参与者将其最严重疼痛评为重度（>6；P<0.001）。尽管对术后严重疼痛高风险患者（患有慢性疼痛或术前疼痛者）的术前识别有所改善，但2013年和2017年分别有27%和0%的此类患者未被记录（P = 0.006）。其他改进计划的措施包括“任何关于POPM的术前讨论”（P<0.001）和“POPM选项讨论”（P = 0.002）。预防性镇痛的使用有所增加（2013年3%的参与者，2017年54%的参与者；P<0.001）。完全没有术后镇痛的参与者比例从2013年的25%降至2017年的5%（P<0.001）。虽然2013年至2017年术后严重疼痛发生率没有改善，但POPM在多项措施上有所改进。这些变化可能归因于当地开展的疼痛研究提高了认识。
