Post operative Pain management in post anesthetic care unit in Maha Sarakham Hospital

Abstract

            Post operative pain usually produces acute pain that it causes suffering in patients. An efficient pain treatment can help decrease physical and psychological damage. Otherwise an inadequate pain treatment can effect decreasing in responding pain stimulation and having complication.

            Objective : To determine pain score in patients using post operative pain guideline used in anesthesia unit, Maha Sarakham hospital; and to develop quality improvement pain guideline to improve treatment outcomes for patients with acute pain.

             Method  :  patients were randomized, 10 to 65 years old and over 65 years, during 1

July to 31December 2009, PACU in Maha  Sarakham hospital. The patients were advised the NRS and VRS pain score before induction. After operation, they were cared in PACU for pain relief by using the post operative pain management guideline.

            Results : The findings revealed that 242 patients, 10 to 65 years old patients with 50 kgs weight and more, received narcotic with the mean of 0.081 mg/kg/hr. comparing with morphine dose; and the mean of pain score is 5.10. Also, in 91 patients with less 50 kgs weight received narcotic showing the mean of 0.99 mg/kg/hr. and pain score is 4.85. In addition, in 16 patients of age group over 65 years with 50 kgs and more, had the mean of receiving narcotic and pain score, 0.89 mg/kg/hr. and 5.31 in order. Moreover, in 7 patients with less 50 kgs weight had the mean of 0.07 mg/kg/hr. in receiving narcotic and 6.16 in pain score.

           Conclusion : This study showed that narcotic dose in this guideline was inadequate analgesia of the two age groups in PACU, having pain score more than 4 in 60 minutes. Consequently, an improvement further pain guideline should be done.