The prevalence of postoperative pain in a sample of 1490 surgical inpatients

Sommer, Michael; Rijke, Janneke M. de; Kleef, Maarten van; Kessels, Alfons G.H.; Peters, Madelon L.; Geurts, José W. J. M.; Gramke, Hans-Fritz; Marcus, Marco A. E.

doi:10.1017/s0265021507003031

Cited by 393 publications

(306 citation statements)

References 25 publications

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“…[1][2][3][4][5][6][7] In a resource-limited environment with an expected high incidence of postoperative pain it is necessary to fully utilise basic analgesic modalities and to reserve more costly advanced methods for those who need it most. For this reason the incidence and risk factors associated with a higher incidence of postoperative pain need to be identified.…”

Section: Introductionmentioning

confidence: 99%

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Acute postoperative pain in 1 231 patients at a developing country referral hospital: incidence and risk factors

Murray

Retief

2015

Southern African Journal of Anaesthesia and Analgesia

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Background: Postoperative pain is poorly studied in developing countries. At a Western Cape referral hospital, it was aimed to determine the incidence of acute postoperative pain, to identify populations associated with a higher risk thereof (in order to guide resource allocation) and to investigate whether inexpensive analgesic modalities are currently utilised maximally. Methods: Patients completed visual analogue scales 24 h after surgery for pain immediately after surgery, maximum pain since surgery and current pain. The incidence of moderate or severe pain and median pain scores were calculated for each scale and for different patient populations. Post hoc logistic regression was performed. Morphine prescriptions were compared with the actual administration thereof. Results: Of 1 231 patients, 62% indicated their maximum pain as moderate or severe. Procedures with the highest incidences were caesarean section and lower limb orthopaedic surgery (> 80%). Younger age, female gender, emergency surgery, and surgery to the abdomen and lower limbs were associated with higher incidences. Patients experiencing moderate or severe pain received 46% of their prescribed morphine. Conclusion: In this institution, the incidence of postoperative pain is high as expected. Associations with postoperative pain are identified, which may guide resource allocation. At least one low-cost analgesic modality is currently underutilised.

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Section: Introductionmentioning

confidence: 99%

“…[2][3][4]8 Most studies only reported on the overall incidence of postoperative pain or compared different methods of analgesia. Few studies that aimed at identifying high-risk groups for practical clinical use were found.…”

Section: Introductionmentioning

confidence: 99%

Acute postoperative pain in 1 231 patients at a developing country referral hospital: incidence and risk factors

Murray

Retief

2015

Southern African Journal of Anaesthesia and Analgesia

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“…[1][2][3][4][5] Opioids have demonstrated efficacy for pain relief after surgery and are often the analgesics of choice for postoperative pain. However, opioid use is frequently accompanied by opioid-related adverse drug events (ORADEs) and other negative consequences, including increased mortality.…”

mentioning

confidence: 99%

Development and Validation of a Risk Score to Identify Patients at High Risk for Opioid-Related Adverse Drug Events

Minkowitz¹,

Scranton

Gruschkus

et al. 2014

JMCP

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BACKGROUND: Opioid-related adverse drug events (ORADEs) are common causes of hospitalization and increased health care costs. OBJECTIVES: To (a) estimate rates of specific adverse drug events (ADEs) among gastrointestinal (GI) surgery patients receiving postoperative opioids; (b) examine the utility of a risk-scoring model in categorizing patients at high risk of experiencing ORADEs; and (c) quantify potential clinical/economic benefits of targeting high-risk GI surgical patients for opioid-sparing regimens in terms of hospitalization cost, length of stay (LOS), and 30-day readmission rates. METHODS: Using a retrospective design based on an administrative database, patients with an inpatient surgical procedure between January 1, 2010, and December 31, 2010, were included. GI surgical patients aged > 18 years followed from admission through 30 days postdischarge were characterized as high or low risk using clinical/demographic characteristics and were evaluated for several outcomes. Using multivariate logistic regression, the ORADE incidence, total hospitalization cost, LOS, and 30-day readmissions were compared for high-risk and low-risk patients. RESULTS: In 87.8% (n = 3,235) of the surgical population, there was a strong concordance between risk assignment and ORADE incidence. Among the remaining 12.2% (n = 449) of patients, 5.5% (n = 202) were low risk with an ORADE, and 6.7% (n = 247) were high risk without an ORADE. Overall, 20.6% (n = 344) of high-risk patients experienced ≥ 1 ORADE (mean cost: $31,988; LOS: 12.1 days) compared with only 5.3% (n = 107) of lowrisk patients (mean cost: $25,216; LOS: 8.0 days). High-risk patients had higher hospitalization costs and longer LOS than low-risk patients, respectively (mean cost: $19,234 vs. $13,036; mean LOS: 6.8 days vs. 3.3 days). These differences correspond to 47.0% higher costs for high-risk patients and an LOS approximately twice as long compared with low-risk patients. CONCLUSIONS: Patient clinical/demographic characteristics influence the risk of developing ORADEs. Risk assessment tools can effectively identify high-risk patients, thereby enabling interventions that can reduce ORADEs, decrease hospital costs, and improve postsurgical experiences for patients.

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“…U Sjedinjenim Američkim Državama, prema navodima njihovih istraživača, kod svakog četvrtog operisanog pacijenta, postoperativni bol je nedovoljno dobro tretiran 5 . Kako navode Sommer i saradnici, u istraživanju kod 1490 pacijenata, uprkos postojanju jasnih smernica, protokola i edukativnih programa za tretiranje ove vrste bola, 86% pacijenata podvrgnutih hirurgiji je prijavilo umereno jak postoperativni bol, čak četvrtog postoperativnog dana 6 . Stoga se u novijim istraživanjima teži ka otkrivanju prediktivnih faktora jačine postoperativnog bola 7,8,9 , a tretman bola je prilagođen njegovoj patofiziologiji 10 .…”

Section: Diskusijaunclassified

Effect of intravenous continual vs. Bolus doses of tramadol and metamizol sodium combination in acute pain management: Continual vs. Bolus doses of tramadol and metamizol combination: Pilot study

Jovičić¹,

Petrovič²,

Gvozdić³

et al. 2016

Serb J Anest Inten Therapy

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The prevalence of postoperative pain in a sample of 1490 surgical inpatients

Abstract: We conclude that despite an acute pain protocol, postoperative pain treatment was unsatisfactory, especially after intermediate and major surgical procedures on an extremity or on the spine.

Cited by 393 publications

References 25 publications

Acute postoperative pain in 1 231 patients at a developing country referral hospital: incidence and risk factors

Acute postoperative pain in 1 231 patients at a developing country referral hospital: incidence and risk factors

Development and Validation of a Risk Score to Identify Patients at High Risk for Opioid-Related Adverse Drug Events

Effect of intravenous continual vs. Bolus doses of tramadol and metamizol sodium combination in acute pain management: Continual vs. Bolus doses of tramadol and metamizol combination: Pilot study

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