Postoperative pain management in adult abdominal surgical patients in general surgical department, Nopparat Rajathanee Hospital

Abstract

Introduction: The research aim was to study the postoperative pain management system in abdominal surgical patients.

Method: Retrospective data collection from patient medical records during January to February 2013.

Result: There were 100 patients from general surgical department, Nopparat Rajathanee Hospital (512 beds) in this study. Appendicitis was the major cause of having surgery. The numerical rating scale was used for assessing pain in most of the patients. All patients received pain evaluation, but with different frequency in each day. The pain evaluation was performed approximately 3 - 5 times/day (1st day after surgery), and decreased to 1 - 2 times/day (2nd and 3rd days after surgery). Pain score evaluated at the first time after surgery was 6.4 ± 2.3 and decreased to 2.4 ± 1.8 (p < 0.001) after analgesics treatment (pain score reduction of 3.9 ± 1.9). Analgesic regimen ordered for controlling severe pain was morphine 3 mg intravenous every 4 hrs prn. Sedative was the common reported adverse effect, and resulted from morphine, however it was the manageable adverse effect.

Disscusion and Conclusion: Postoperative pain management from analgesics can significantly decrease pain score. However, adjustment for the frequency of pain evaluation is needed for the better pain management system. Pain evaluation as the fifth vital sign can provide the opportunity to monitor and manage the pain with the drug and regimen that suited the pain scores.

Key words: Pain management, Abdominal surgery, General surgery