A Comparison of Traditional and New Acute Postoperative Pain Guideline on Severe Postoperative Pain Score at 1 Hour in Patients Undergoing Abdominal Surgery at Chaoprayayommarat Hospital

Abstract

Objective: To compare the proportion of the patients with severe pain score at 60 minutes after the surgery between the group that received a conventional and new postoperative pain management guideline.

Materials and methods: A randomized, single-blind clinical trial was done in patients receiving abdominal surgery and general anesthesia at Chaophrayayommarat hospital Suphanburi. The data were collected in the recovery room, between January, 1 2017 and October, 31 2018. The samples were randomized by using the computer-based random number generators to a conventional postoperative pain management guideline group (n=102) received intravenous morphine 3 mg every 10 minutes when pain scores (numeric rating scale; NRS) >3 and a new postoperative pain management guideline (n=102) group received 2, 4 and 6 mg of morphine if NRS1–3, 4-6 and 7–10, respectively. NRS at 5, 30, 45 and 60 minutes were recorded.The instrument used recording the basic information. Information to anaesthesia during surgery. Save the information in the recovery room after surgery. Data were analysed with a chi-square test.

Results: At 45minutes postoperative surgery, mild NRS in the new group (56.9 %) Moderate pain 17.6%, was statistically significant greater than the conventional group (38.2 %) Moderate pain 37.5%, p=0.009. At 5, 30 and 60 minutes postoperative surgery, there were not statistically significant difference of NRS between 2 groups. Severe NRS in the new and conventional group was 7.8% and 5.9%, respectively. We found only one person had nausea and vomiting. No other adverse events such as respiratory depression were found in both group.

Conclusion: A new postoperative pain management guideline is an alternative in severe acute pain treatment in patients undergoing abdominal surgery due to better pain control at 45minutes than an old one in the recovery room without severe adverse event.