Effect of pain management in patients undergoing laparoscopic cholecystectomy in Wanonniwas Hospital.

Abstract

This quasi-experimental research aimed to study the effect of postoperative pain management in patients undergoing laparoscopic cholecystectomy (LC) applying a modified clinical nursing practice guideline (CNPG) of LC pain management.  Data were collected at surgical ward 1 and 2 in Wanonniwas Hospital.  A total of 30 elective LC patients completed questionnaires which consisted of three parts: 1) patients’ demographic data, 2) post LC pain scale assessment, and 3) satisfaction toward post LC pain management following CNPG. The reliability of the third part, satisfaction questionnaire, was 0.80. Demographic data were analyzed using descriptive statistics, frequency, percentage, mean and standard deviation. Paired T-Test was used to compare mean scores between pain management at different intervals after post-operation. While repeated measure ANOVA was used to compare a total of mean scores of pain after post-operation. 

The mean score of LC postoperative was found to be significantly lower hour by hour after pain management.  They reported pain score at moderate level within four hours, and low level within 24 hours of post-operation.  In detail, pain sore at the 2^nd, 4^th , 6^th , 8^th , 16^th and 24^th were 6.7(S.D.=1.63), 5.3(S.D.= 1.39) , 3.9(S.D.= 1.51), 3.4(S.D.=1.57), 1.9(S.D.=1.06)  and 0.8 (S.D.= 0.38). A total pain score showed statistically different (p-value< 0.01).  The satisfaction of patients toward pain management were pointed at the highest level (  =3.90, S.D.=0.30).

This research suggested that pain management for LC following CNPG should be generally applied to other LC patients.