Amberbir Wubet Dessie, Bayable Samuel Debas, Fetene Melaku Bantie
Department of Anesthesia, Menelik II Health Science College, Addis Abeba.
Department of Anesthesia, College of Medicine and Health Science, Debre Markos University, Debre Markos.
Ann Med Surg (Lond). 2023 Apr 27;85(6):2506-2511. doi: 10.1097/MS9.0000000000000716. eCollection 2023 Jun.
Postoperative pain is an expected and undesirable by-product of all surgical procedures. The provision of effective and safe postoperative pain management should be one of the top priorities of any healthcare, where surgical procedures are carried out. Major abdominal surgical operations require pain management services, regular pain assessment, and timely management of breakthrough pains in the postoperative period.
This study aimed to determine the prevalence and factors associated with acute postoperative pain.
A cross-sectional study was conducted at Minilik and Zewditu Referral hospitals from October to December 2021 and chart review and face-to-face interviews were the methods of data collection. The pain was measured at the 2, 12, and 24 h postoperatively through a numerical rating scale, and the pain was categorized as no pain (score=0), mild pain (score 1-3), moderate pain (score 4-6), or severe pain (score 7-10). All independent variables with P less than or equal to 0.2 in the univariable logistic regression were reanalyzed with multivariable logistic regression at 95% CI to determine predictive factors and a -value of less than 0.05 was considered statistically significant.
In the study period, a total of 368 eligible patients were involved, out of this 11 patients were discharged before 24 h, four patients refuse to participate two incomplete documentation and one patient was ICU admitted, therefore 350 patients were involved with a response rate of 95.1%. Among those patients 73.1% of respondents' experience at least one episodes of moderate to severe postoperative pain within the first 24 h. Preoperative anxiety (AOR: 2.2, 95% CI: 1.2, 5.1), urban residency (AOR: 2.3, 95% CI: 1.2, 50), participants who have not formal education (AOR: 2.5, 95% CI: 1.3, 4.1), surgical patients without pre-emptive analgesia (AOR: 2.7, 95% CI: 1.3, 3.6), abdominal incision greater than 10 cm (AOR: 3.5, 95% CI: 2.1, 7.2), and surgical duration greater than or equal to 60 min (AOR: 2.3, 95% CI: 1.1, 3.1) were factors associated with acute postoperative pain following elective gynecologic surgery.
In this study, the overall incidence of moderate to severe postoperative pain after gynecologic surgery was unacceptably high, and patients undergoing gynecologic surgical procedures suffer sufficient postoperative pain need of intervention.
术后疼痛是所有外科手术预期且不良的副产品。提供有效且安全的术后疼痛管理应是任何开展外科手术的医疗保健机构的首要任务之一。大型腹部外科手术在术后需要疼痛管理服务、定期疼痛评估以及及时处理突发疼痛。
本研究旨在确定急性术后疼痛的患病率及相关因素。
2021年10月至12月在米尼利克和泽韦迪图转诊医院进行了一项横断面研究，数据收集方法为病历审查和面对面访谈。术后2小时、12小时和24小时通过数字评分量表测量疼痛程度，疼痛分为无痛（评分=0）、轻度疼痛（评分1 - 3）、中度疼痛（评分4 - 6）或重度疼痛（评分7 - 10）。单变量逻辑回归中P值小于或等于0.2的所有自变量在95%置信区间下用多变量逻辑回归重新分析，以确定预测因素，P值小于0.05被认为具有统计学意义。
在研究期间，共有368名符合条件的患者参与，其中11名患者在24小时前出院，4名患者拒绝参与，2份记录不完整，1名患者入住重症监护病房，因此350名患者参与，应答率为95.1%。在这些患者中，73.1%的受访者在术后24小时内至少经历过一次中度至重度术后疼痛。术前焦虑（比值比：2.2，95%置信区间：1.2，5.1）、城市居住（比值比：2.3，95%置信区间：1.2，5.0）、未接受正规教育的参与者（比值比：2.5，95%置信区间：1.3，4.1）、未进行预防性镇痛的手术患者（比值比：2.7，95%置信区间：1.3，3.6）、腹部切口大于10厘米（比值比：3.5，95%置信区间：2.1，7.2）以及手术持续时间大于或等于60分钟（比值比：2.3，95%置信区间：1.1，3.1）是择期妇科手术后急性术后疼痛的相关因素。
在本研究中，妇科手术后中度至重度术后疼痛的总体发生率高得令人无法接受，接受妇科手术的患者术后疼痛严重，需要进行干预。
