Postoperative Pain Management and Patient Satisfaction in an Indian Tertiary Care Centre-A Prospective Observational Study
UC31-UC34
Correspondence
Mohit K Srivastava,
Senior Resident (DM Pain Medicine), Department of Physical Medicine and Rehabilitation, AIIMS, Rishikesh, Dehradun-249203, Uttrakhand, India.
E-mail: rohitsriv14elec@gmail.com
Introduction: Despite various advancements over last two decades in pain medicine, postoperative pain remains inadequately addressed, even in a tertiary medical centre. There are very limited studies addressing postoperative pain management in India. Few published studies have assessed postoperative pain, but only at 24 hours intervals, and utilising tools focusing on any one parameter of pain. Hence, a holistic assessment using four different pain assessment tools should be done to get a wider overview of the condition.
Aim: To assess the intensity and severity of postoperative pain at 6, 12, 24 and 48 hours postoperatively for patients undergoing surgery for orthopaedics, gastrointestinal, general surgery, obstetrics and gynaecological ailments and patient satisfaction at 24 hours postoperatively.
Materials and Methods: A prospective observational survey was conducted at a tertiary care centre of New Delhi, India from October 2020 to October 2021. Three scales were used to determine the status of postoperative pain at 6,12,24 and 48 hours follow-up. The three different pain scales were Numerical Pain Rating Scale (NRS-pain) static and dynamic, Global Perceived Effect (GPE) and Neuropathic Pain System Inventory (NPSI).
Results: Total of 400 patients, with mean age of the study population was 43.26±4.98 years. Majority were males, 250 (60%) and of American Society of Anaesthesiologist (ASA) Grade I, 208 (52%). Significant improvement was observed in the NRS pain score at each follow-up among those undergoing orthopaedic surgery, general surgery, and gynaecological procedures. Improvement in the mean GPE scale was only seen for orthopaedic surgeries. There was a significant neuropathic pain component observed in all the surgeries except gynaecological surgeries. Majority 321 (80.25%) had received information about their pain treatment but only 174 (43.5%) were satisfied with their pain treatment.
Conclusion: A majority of the patients undergoing orthopaedic or general surgery, and gynaecological procedures had improvement in pain. This survey highlights the need for investigating future postoperative pain management protocols so that the intensity of postoperative pain, incidence of chronic persistent pain and resulting suffering, as well as disability, can be minimised to a large extent.