A survey of postoperative epidural and intravenous analgesia in Greece

Tzavellas, P.; Papilas, Konstantinos; Grigoropoulou, I.; Zolindaki, C.; Kouki, Pinelopi; Chrona, H.; Kostopanagiotou, Georgia

doi:10.1017/s0265021507001160

Cited by 4 publications

(7 citation statements)

References 40 publications

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“…This finding is in accordance with the results of a recent survey on postoperative analgesia, reporting that epidural catheters were used in 44.5% of Greek Anesthesia Departments. [ 19 ] Similarly, data from Sweden showed that spinals were chosen for short lasting surgical procedures (up to 1 h), while epidurals and CSEs were preferred when postoperative epidural analgesia was planned. [ 8 ]…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, such participation rates are relative common in national surveys with a design similar to ours. [ 8 10 19 ] We also consider that our sample size [anesthesiologists ( n = 345) and surgical procedures ( n = 187,703)] is adequate, taking into account the country population. Furthermore, the participating departments were distributed to all major Greek Health Districts, and thus we consider that the results are representative and can be extrapolated nationally.…”

Section: Discussionmentioning

confidence: 99%

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Regional anesthesia practice in Greece: A census report

Αrgyra

Μoka

Staikou

et al. 2015

J Anaesthesiol Clin Pharmacol

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Background and Aims:Regional anesthesia (RA) techniques (central neuraxial and peripheral nerve blocks [CNBs and PNBs]) are well-established anesthesia/analgesia modalities. However, information on their nationwide use is sparse. The aim of the survey was to assess the utility of RA techniques in Greece, during 2011.Materials and Methods:A nationwide, cross-sectional descriptive survey was conducted (March to June, 2012), using a structured questionnaire that was sent to 128 Greek Anesthesia Departments.Results:Sixty-six completed questionnaires (response rate 51.56%) were analyzed. The data corresponded to 187,703 operations and represented all hospital categories and geographical regions of Greece. On the whole, RA was used in 45.5% of performed surgical procedures (85,386/187,703). Spinal anesthesia was the technique of choice (51.9% of all RA techniques), mostly preferred in orthopedics (44.8%). Epidural anesthesia/analgesia (application rate of 23.2%), was mostly used in obstetrics and gynecology (50.4%). Combined spinal-epidural and PNBs were less commonly instituted (11.24% and 13.64% of all RA techniques, respectively). Most PNBs (78.5%) were performed with a neurostimulator, while elicitation of paresthesia was used in 16% of the cases. Conversely, ultrasound guidance was quite limited (5%). The vast majority of consultant anesthesologists (94.49%) were familiar with CNBs, whereas only 46.4% were familiar with PNBs. The main reported limitations to RA application were lack of equipment (58.23%) and inadequate education/training (49.29%).Conclusion:Regional modalities were routinely used by Greek anesthesiologists during 2011. Neuraxial blocks, especially spinal anesthesia, were preferred over PNBs. The underutilization of certain RA techniques was attributed to lack of equipment and inadequate training.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Regional anesthesia practice in Greece: A census report

Αrgyra

Μoka

Staikou

et al. 2015

J Anaesthesiol Clin Pharmacol

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“…D espite significant advances in knowledge and in evidence-based interventions, studies continue to report ineffective pain management for acute postoperative pain (Apfelbaum, Chen, Mehta, & Gan, 2003;Gunningberg & Idvall, 2007;Svensson, Sjöström, & Haljamäe, 2001;Tzavellas et al, 2007;Wang & An, 2001). Standards are being developed across the world to guide patient care interventions, increase provider awareness, and monitor outcomes of pain management (American Pain Society [APS], 1995[APS], , 1999American Society of Anesthesiologists, 1995;Australian and New Zealand College of Anaesthetists, 2005;Berry & Dahl, 2000;National Health and Medical Research Council, 1999) though integrative reports reveal ongoing challenges in changing outcomes (Gordon et al, 2005;Max et al, 1991).…”

mentioning

confidence: 99%

“…Standards are being developed across the world to guide patient care interventions, increase provider awareness, and monitor outcomes of pain management (American Pain Society [APS], 1995[APS], , 1999American Society of Anesthesiologists, 1995;Australian and New Zealand College of Anaesthetists, 2005;Berry & Dahl, 2000;National Health and Medical Research Council, 1999) though integrative reports reveal ongoing challenges in changing outcomes (Gordon et al, 2005;Max et al, 1991). Studies continue to demonstrate few changes during the past decade in the inadequacies of postoperative pain management (Dihle, Helseth, Kongsgaard, Paul, & Miaskowski, 2006;Gunningberg & Idvall, 2007;Lee, Chen, & Ngan Kee, 2003;Tzavellas et al, 2007). Mismanaging postoperative pain has a high price; it can lead to negative physiologic and psychological consequences, delay recovery, and have ethical and economic consequences (Kehlet & Dahl, 2003;Rosenberg & Kehlet, 1999).…”

mentioning

confidence: 99%

“…Reports from postoperative patients indicate continuing issues with applying the APS standards, in spite of clear treatment guidelines Tzavellas et al, 2007). To address disparity 976 Western Journal of Nursing Research in treating postoperative pain in Hispanics, McNeill et al (2003) developed a pain outcome instrument in Spanish, the Houston Patient Outcome Instrument (HPOI), modeled on the prototype APS-POQ and refined through qualitative interviews .…”

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confidence: 99%

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Postoperative Pain Management Outcome in Chinese Inpatients

et al. 2008

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In the absence of pain management outcome reports representing mainland China, the purposes of this study were to describe the outcome of postoperative pain management and the relationship between patient satisfaction and clinical outcomes in an indigenous Chinese population. From a sample of 388 second-day-postoperative inpatients, 304 (78%) reported pain in the past 24 hours and were enrolled in the study. Mean ratings for pain were moderate to severe. Patients reported mild to moderate pain-related interference with mood and physical activities. There were significant differences on worst pain intensity and pain interference with daily activity in the past 24 hours for different types of surgery. Top-ranked nonpharmacologic methods for managing pain were tolerating pain, changing positions, and family support. As measured by the Pain Management Index, 60.2% of patients were inadequately treated for pain, yet patients reported high satisfaction with pain management. Patient satisfaction, however, was inversely and significantly correlated with pain intensity. Study results indicate a need for standardized policies and guidelines about pain management and education among providers and for patients and families to overcome the suboptimal pain outcomes among this Chinese population.

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