Acute postoperative pain management at a tertiary hospital in Addis Ababa, Ethiopia: A prospective crosssectional study

Abstract

Background

The success of a surgical procedure is determined by many factors; - including appropriate pain control. Management of post-op­erative pain reduces suffering and leads to earlier mobilization, promotes wound healing and recovery, shortens hospital stay, reduces hospital costs, and increases patient satisfaction.

Although the mechanisms of pain increasingly well understood, and novel, safe analgesics and techniques of anaesthesia are introduced, the level of postoperative pain relief is still unsatisfactory. Post-operative pain control regimens are not standardized; rather, tailored to the needs of the individual patient.

Methods

A prospective cross-sectional study was conducted October 1-31st 2016. Predesigned structured data collection format used to abstract the medications provided to each patient and to interview patients. We used convenience sampling technique. Post-op­erative pain (POP) and patients’ satisfaction with pain relief scores were assessed by using pain numerical rating scales. Pain as­sessment was done after 24hours of surgery and at discharge or fifth POD. We used descriptive analysis to determine the degree of control of pain and carried out bivariate and multivariable analysis to determine factors affecting the level of pain control and patient satisfaction using SPSS version 20.

Results

Five hundred & twenty-four patients were included in the prospective study. Two hundred sixty-one patients (49.7%) were found to have moderate to severe pain at first POD and 138 patients (26.3%) had moderate to severe pain during discharge or at fifth POD. Four hundred eighty-three patients (92.2%) were satisfied with POP pain management. Emergency procedures & duration of surgery above one hour were found to be independent risk factors for POP pain while educational status above secondary school was independently associated with POP management satisfaction.

Conclusions

The study showed postoperative pain management is still a challenge in our setting. Most patients developed moderate to severe postoperative pain while they are on pain management but reported a high level of POP pain satisfaction.