Subcutaneous ketamine for postoperative pain relief in Rwanda: a randomized clinical trial

Sacevich, Calen; Semakuba, Benjamin; McKay, William P. S.; Thakore, Shefali; Twagirumugabe, Théogène; Nyiligira, John

doi:10.1007/s12630-017-1009-7

Cited by 4 publications

(6 citation statements)

References 21 publications

(25 reference statements)

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“… 2 Between our surveys, two further POPM studies were conducted by our group in the operating rooms and surgical wards at CHUK. 25 , 26 Resident awareness of POPM as an integral part of patient care was heightened over the years from 2010 to 2018. This is borne out by anesthesia faculty members, Dr. Gaston Nyirigira and coauthor Dr. Eugene Tuyishime, who trained during that period and who initiated the first international postoperative pain control educational meeting (Zero Pain Rwanda), held in Rwanda in January 2019.…”

Section: Discussionmentioning

confidence: 99%

“…The IPO questionnaire 26 has been validated mainly for European and Israeli populations. No current studies exist for the validation of the IPO questionnaire in any African population.…”

Section: Discussionmentioning

confidence: 99%

“…in 2010. Since those discussions, our group has implemented a research program to improve POPM in CHUK consisting of the first survey reported here (2013), followed by a dose-finding study of low-dose subcutaneous ketamine (2015), 25 a randomized clinical trial of low-dose subcutaneous ketamine (2016), 26 the 2017 survey, and meetings to discuss implementation of the Essential Pain Management™ program at CHUK (2018). A survey of pediatric POPM is approved for 2019.…”

Section: Discussionmentioning

confidence: 99%

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Surveys of post-operative pain management in a teaching hospital in Rwanda — 2013 and 2017

McKay

Lee

Masu

et al. 2019

Canadian Journal of Pain

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Background: Postoperative pain management (POPM) appeared to be weak in Rwanda. Aims: The aim of this study was to compare POPM measures in a teaching hospital between 2013 and 2017. Methods: 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. Results: 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; P < 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 (P = 0.006). Other measures of improved planning included "any preoperative discussion of POPM" (P < 0.001) and "discussion of POPM options" (P = 0.002). Preemptive analgesia use increased (3% of participants in 2013 and 54% in 2017; P < 0.001). Incidence of participants having no postoperative analgesic at all decreased from 25% in 2013 to 5% in 2017 (P < 0.001). Conclusions: 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. RÉSUMÉContexte : La prise en charge de la douleur postopératoire (POPM) semblait faible au Rwanda. Objectifs : Comparer les mesures de prise en charge de la douleur postopératoire dans un hôpital d'enseignement entre 2013 et 2017. Méthodes : Étude observationnelle en deux phases réalisée en 2013 et 2017; les participants ont été recrutés avant de subir une chirurgie majeure et ont été suivis pendant deux jours après l'opération. Une échelle de notation numérique (0 à 10) a été administrée à tous les participants les deux années, tandis que le questionnaire International Pain Outcomes a été administré en 2017. Le recrutement, le consentement et toutes les collectes de données se sont déroulés dans la langue préférée par les participants. Résultats : Cent participants adultes ayant subi une chirurgie générale, gynécologique, orthopédique ou urologique majeure ont été recrutés en 2013; 83 en 2017. Quatorze pour cent des participants ont qualifié leur pire douleur de sévère (> 6) en 2013, et 46 % en 2017 (p = 0,001). Cela est survenu malgré l'amélioration de la reconnaissance préopératoire des patients à haut risque de douleur postopératoire sévère (ceux atteints de douleur chronique ou de douleur préopératoire); 27 % de ces patients n'ont pas été documentés en 2013 ; 0 % en 2017, p < 0,006. Parmi les autres mesures de planification améliorée, mentionno...

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Section: Discussionmentioning

confidence: 99%

“…The IPO questionnaire 26 has been validated mainly for European and Israeli populations. No current studies exist for the validation of the IPO questionnaire in any African population.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Surveys of post-operative pain management in a teaching hospital in Rwanda — 2013 and 2017

McKay

Lee

Masu

et al. 2019

Canadian Journal of Pain

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“…1 To conduct a randomized-controlled trial in a low-income country is an arduous task, and the authors should be congratulated for this effort.…”

mentioning

confidence: 99%

Postoperative pain and study design: the type of surgical procedure matters

Kendall

2018

Can J Anesth/J Can Anesth

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“…Thank you for your interesting observations 1 regarding our recent report. 2 It is indeed challenging to do clinical studies in low-income countries (LICs). Regarding our definition of major surgery, the field has been fraught for more than half a century, but a recent study defined it as ''… surgeries required general, epidural, or spinal anesthesia, and hospitalization for more than one day''.…”

mentioning

confidence: 99%

In reply: Postoperative pain and study design: the type of surgical procedure matters

Sacevich

Semakuba

McKay

et al. 2018

Can J Anesth/J Can Anesth

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Subcutaneous ketamine for postoperative pain relief in Rwanda: a randomized clinical trial

Cited by 4 publications

References 21 publications

Surveys of post-operative pain management in a teaching hospital in Rwanda — 2013 and 2017

Surveys of post-operative pain management in a teaching hospital in Rwanda — 2013 and 2017

Postoperative pain and study design: the type of surgical procedure matters

In reply: Postoperative pain and study design: the type of surgical procedure matters

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