Assess Level of Post-operative Pain in Adult Patients who Underwent Elective Surgery Using Pre-printed Postoperative Pain Order in Vajira Hospital

Abstract

Objectives: To assess level of pain intensity (Numerical Rating Scale) in patients who underwent elective general surgery, colorectal surgery, urological surgery, ENT surgery, plastic surgery and orthopedic surgery at recovery room, arrival to ward, 4^th, 8^th, 16^th, 32^nd and 48^th hour post-operatively using pre-printed post-operative pain order prescribed by surgeon. Secondary outcome is to study the incidence of serious adverse events after administering opioid such as deep sedation (Sedation Score=3) or respiratory depression (Respiratory rate <10/min) during using this pre-printed post-operative pain order protocol.

Study design: Descriptive study Subject: Data was obtained during January to March, 2017 with sample size of 370 patients. Methods: Personal and clinical information, types of surgery, anesthetic techniques and pain score at recovery room, arrival to ward, 4^th, 8^th, 16^th, 32^nd and 48^th hour post-operatively were collected for analysis. Using descriptive statistics such as frequency, percentage, mean and standard deviation. Main outcome measures : Pain score at various time interval during 48 hours post-operative period.

Results : From 370 participants, 187 male patients (50.54%), median age was 54.3 ±14.82 years and 183 female patients (49.46%), median age was 55.5 ±14.96 years. Patients’ mean pain score at recovery room was 3.94 ±4.31, arrival to ward was 3.06 ±2.89, 4^th hour post-operatively was 3.03 ±2.62, 8^th hour post-operatively was 3.11 ±2.50, 16^th hour post-operatively was 2.58 ±2.28, 24^th hour post-operatively was 2.31 ±2.12, 32^nd hour post-operatively was 1.89 ±2.10 and 48^th hour post-operatively was 1.25 ±1.61 respectively. And during this study we found no incidence of serious complications regarding using opioid such as deep sedation or respiratory depression.

Conclusion : Patients who were prescribed post-operative pain order using pre-printed order by surgeon for elective general surgery, colorectal surgery, urological surgery, ENT surgery, plastic surgery and orthopedic surgery had mean pain score at recovery room 3.94 ±4.31, arrival to ward 3.06 ±2.89, 4^th hour post-operatively 3.03 ±2.62, 8^th hour post-operatively 3.11 ±2.50, 16^th hour post-operatively 2.58 ±2.28, 24^th hour post-operatively 2.31 ±2.12, 32^nd hour post-operatively 1.89 ±2.10 and 48^th hour post-operatively 1.25 ±1.61 respectively. And we found no incidence of serious complications regarding opioid administration for pain relief. Thus we support the usage of pre-printed post-operative pain order prescribed by surgeon in the hospital.