Bakshi Sumitra G, Arya K, Dhurwe Badal
Department of Anesthesia, Critical Care and Pain Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India.
J Anaesthesiol Clin Pharmacol. 2024 Oct-Dec;40(4):588-597. doi: 10.4103/joacp.joacp_198_22. Epub 2024 Jul 19.
For the aggressive treatment of postoperative pain, nonpharmacological methods (NPMs) are gaining importance complementary to routine multimodal pain management. The primary aim of the study was to assess the incidence of use of NPMs in our hospital. Secondary objectives were to correlate the pain scores, patient satisfaction, and percentage of time the patient was in severe pain within 72 h postsurgery with the use of NPMs when in pain/not in pain. The effect of NPMs on the physical and emotional outcome of patients as per the American Pain Society Patient Outcome Questionnaire (APS-POQ) was also assessed.
After obtaining approval from the institutional ethics committee (IEC), the trial was registered with the Clinical Trials Registry of India (CTRI). Informed consent was obtained from adult patients on the third postoperative day of elective surgeries. Their responses to the APS-POQ and to a few additional questions about their beliefs on the use of NPM were recorded.
Only one-fourth of the total study population were using NPMs for pain management in the hospital. After propensity matching for surgery and postoperative analgesia, two groups were made: one using NPM for pain relief ( = 49) and the other not using NPM ( = 98). There was no significant difference among the satisfaction score ( = 0.31), least pain score ( = 0.68), and worst pain score ( = 0.43) within 72 h postoperatively in either of the groups. Emotional and physical outcomes as per the APS-POQ were similar in both the groups.
NPMs are rarely practiced and used during postoperative pain in our hospital. No difference in pain scores, patient satisfaction, and emotional and physical outcomes of the APS-POQ was seen in the group that indulged in NPMs.
对于术后疼痛的积极治疗,非药物方法(NPMs)作为常规多模式疼痛管理的补充正变得越来越重要。本研究的主要目的是评估我院NPMs的使用发生率。次要目标是将疼痛评分、患者满意度以及患者术后72小时内处于剧痛状态的时间百分比与疼痛时/无疼痛时使用NPMs的情况进行关联。还评估了根据美国疼痛学会患者结局问卷(APS-POQ),NPMs对患者身体和情绪结局的影响。
在获得机构伦理委员会(IEC)批准后,该试验在印度临床试验注册中心(CTRI)进行了注册。在择期手术的成年患者术后第三天获得知情同意。记录他们对APS-POQ的回答以及关于他们对NPMs使用信念的一些其他问题的回答。
在医院中,仅四分之一的研究总人群使用NPMs进行疼痛管理。在对手术和术后镇痛进行倾向匹配后,分为两组:一组使用NPM缓解疼痛(n = 49),另一组不使用NPM(n = 98)。两组术后72小时内的满意度评分(P = 0.31)、最小疼痛评分(P = 0.68)和最大疼痛评分(P = 0.43)均无显著差异。两组根据APS-POQ得出的情绪和身体结局相似。
在我院,术后疼痛期间很少实施和使用NPMs。在使用NPMs的组中,疼痛评分、患者满意度以及APS-POQ的情绪和身体结局均无差异。