Factors affecting postoperative pain and delay in discharge from the post-anaesthesia care unit: A descriptive correlational study

Abstract

Background: Pain occurring in the post-anaesthesia care unit (PACU) is common, distressing to patients and remains a management challenge for staff. This study aims to identify the factors affecting pain severity and delay in discharge of patients from the PACU. Methods: Data from 590 consecutive postoperative patients in the PACU was collected over one month in 2012 at the Singapore General Hospital. Patient demographics, surgical, intraoperative anaesthetic and recovery data were collected. The primary outcome measured was postoperative pain score and secondary outcome was a delay in discharge. Univariate and multivariate logistic regression were performed to determine preoperative and intraoperative variables that may be associated with pain and delayed discharge. Results: The majority (67.6%) of patients reported no to mild pain while 32.3% reported moderate to severe pain; 65.4% of patients had delayed discharge and 28.3% of these were a result of uncontrolled pain. Factors associated with moderate to severe postoperative pain included younger age, same day admissions, duration of operation >2 h, abdominal, upper limb and spine surgeries and use of general anaesthesia. Factors associated with delay in discharge included higher body mass index, abdominal, spine and superficial surgeries, use of general anaesthesia, moderate to severe pain score and use of nurse controlled analgesia. Conclusions: This study identifies predictive factors for postoperative pain and delay in discharge from the PACU. Knowledge of these factors may help in better clinical judgment for postoperative pain management and can lead to quality improvement measures for patient management and work flow in the PACU.

Assessment of Pain Severity and Associated Factors of Post Operative Pain Among Adult Patients in Public Hospitals of Addis Ababa, Ethiopia, 2021

“…Similarly, our study result was higher than the studies conducted in Singapore (32.2%), Eastern Poland (59%), Dutch (41%), South Africa 62 %, and Mekelle (30.5%), (7,9,(15)(16)(17)(18). This variation may be due to differences in infrastructure, a postoperative pain management protocol, sample size, and pain assessment time.…”

“…Advances in pharmacology, techniques, and education are making major inroads into the management of postoperative pain (5). Post-operation pain intensity is associated with variables like patient age, sex, type of surgery, anesthesia, duration of surgery and previous pain experience of the patient are some of the factors associated with moderate to severe postoperative pain development (6,7).…”

The Use of Determinants of Length of Stay in the Post-anesthesia Care Unit (PACU) at the Philippine General Hospital among Postoperative Patients who Underwent Elective Surgeries to Create a Predictive Model for PACU Length of Stay

“…5 Chan et al identified higher body mass index; abdominal, spine and superficial surgeries; use of general anesthesia; moderate to severe pain score; and use of nurse controlled analgesia as factors that delay discharge from PACU. 9 Imasogie and Chung in 2002 classified the risk factors for prolonged PACU stay after ambulatory surgery into preoperative, intraoperative, and postoperative. The preoperative risk factors included the type of surgery, pre-existing congestive heart failure, and increasing age.…”

Quantitative Sensory Testing to Predict Postoperative Pain

“…Persistent acute pain leads to prolonged recovery, to delayed discharge from the hospital, and to higher re-admission rates, which can significantly increase the costs of treatment [ 8 – 10 ].…”