Observational study of post-operative pain control before and after the implementation of a clinical practice guideline for postoperative pain management.

Estudio observacional del control del dolor postoperatorio antes y después de la implementación de una guía del manejo del dolor postoperatorio.

Journal

Medicina clinica
ISSN: 1578-8989
Titre abrégé: Med Clin (Barc)
Pays: Spain
ID NLM: 0376377

Informations de publication

Date de publication:
25 10 2019
Historique:
received: 01 07 2018
revised: 21 01 2019
accepted: 24 01 2019
pubmed: 17 4 2019
medline: 21 10 2020
entrez: 17 4 2019
Statut: ppublish

Résumé

Postoperative pain is common in hospitals. Clinical practice guidelines for the control of postoperative pain (CPGPP) have been developed to improve its treatment. The objective of this study was to evaluate the prevalence and intensity of postoperative pain and analgesic norms, before and after the implementation of a CPGPP. An observational study was carried out that included 2cross-sectional studies in 2separate periods, before and after implementation of the CPGPP. Adult patients postoperated on the first day of admission in the surgery plants were included. Demographic, clinical and pharmacological variables were collected from clinical histories. The intensity of the pain was collected through individual interviews with patients. We included 306 patients in the first period and 317 in the second. There were no differences between patients' demographic and clinical variables and the 2periods. The prevalence of pain was 92% (IC 95%: 87%-95%) in the first period and 77% (IC 95%: 72%-82%) in the second (P <0.05). The most frequent pain in the last 24hours was moderate or intense in 53% (IC 95%: 48%-59%) of patients in the first period and in 33% (IC 95%: 28%-38%) of the patients in the second (P <0.05). After the implementation of the CPGPP, a decrease in the prevalence and intensity of pain in patients was observed, but without reaching an optimal level. Continued pain training and assessment measures are therefore necessary for proper pain treatment over time.

Sections du résumé

BACKGROUND AND OBJECTIVES
Postoperative pain is common in hospitals. Clinical practice guidelines for the control of postoperative pain (CPGPP) have been developed to improve its treatment. The objective of this study was to evaluate the prevalence and intensity of postoperative pain and analgesic norms, before and after the implementation of a CPGPP.
MATERIAL AND METHOD
An observational study was carried out that included 2cross-sectional studies in 2separate periods, before and after implementation of the CPGPP. Adult patients postoperated on the first day of admission in the surgery plants were included. Demographic, clinical and pharmacological variables were collected from clinical histories. The intensity of the pain was collected through individual interviews with patients.
RESULTS
We included 306 patients in the first period and 317 in the second. There were no differences between patients' demographic and clinical variables and the 2periods. The prevalence of pain was 92% (IC 95%: 87%-95%) in the first period and 77% (IC 95%: 72%-82%) in the second (P <0.05). The most frequent pain in the last 24hours was moderate or intense in 53% (IC 95%: 48%-59%) of patients in the first period and in 33% (IC 95%: 28%-38%) of the patients in the second (P <0.05).
CONCLUSIONS
After the implementation of the CPGPP, a decrease in the prevalence and intensity of pain in patients was observed, but without reaching an optimal level. Continued pain training and assessment measures are therefore necessary for proper pain treatment over time.

Identifiants

pubmed: 30987819
pii: S0025-7753(19)30131-9
doi: 10.1016/j.medcli.2019.01.035
pii:
doi:

Substances chimiques

Analgesics 0

Types de publication

Journal Article Observational Study

Langues

eng spa

Sous-ensembles de citation

IM

Pagination

312-318

Investigateurs

Gloria Agreda Martínez (G)
Cristina Aguilera Martín (C)
Carme Bosch Graupera (C)
Dolors Botella Samaranch (D)
Jesús Caballero López (J)
María Victoria García Aparicio (M)
Jordi García López (J)
Pilar Gil Rubio (P)
Lluís Gros Subias (L)
Esther Les Morell (E)
Ángeles Mesas Idáñez (Á)
Concepción Muñoz Alcaide (C)
Maria Oliveras Arena (M)
Dolors Planas Gras (D)
Lucrecia Ramírez Garceran (L)
María Victoria Ribera Canudas (M)
Sabina Salicrú Riera (S)
Ana María Sánchez Reyes (A)
Trinidad Trull Ventura (T)
Antoni Vallano Ferraz (A)

Informations de copyright

Copyright © 2019 Elsevier España, S.L.U. All rights reserved.

Auteurs

Ángeles Mesas Idáñez (Á)

Servicio de Anestesiología, Hospital Universitario Vall d'Hebron, Barcelona, España; Unidad del dolor, Servicio de Anestesiología, Hospital Universitario Vall d'Hebron, Barcelona, España; Subcomisión del dolor, Hospital Universitario Vall d'Hebron, Barcelona, España; Universidad Autónoma de Barcelona, Barcelona, España. Electronic address: amesas@vhebron.net.

Cristina Aguilera Martin (C)

Subcomisión del dolor, Hospital Universitario Vall d'Hebron, Barcelona, España; Servicio de Farmacología Clínica, Hospital Universitario Vall d'Hebron, Barcelona, España; Universidad Autónoma de Barcelona, Barcelona, España.

Concepción Muñoz Alcaide (C)

Universidad Autónoma de Barcelona, Barcelona, España.

Antonio Vallano Ferraz (A)

Departamento de Patología y Terapéutica Experimental, Universidad de Barcelona, Barcelona, España.

M Victoria Ribera Canudas (MV)

Sociedad Catalana del Dolor, Barcelona, España.

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Classifications MeSH