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Abstract
Background and Aims Incidence of acute post-operative pain varies widely in different studies and is largely undertreated. Role of a protocolised acute pain service in alleviating postoperative pain is well recognised. Absence of a dedicated acute pain team due to logistics often acts as an impediment in delivering this service. In this retrospective audit, we have compared the results of acute postoperative pain management before and after implementing acute pain service.
Methods Two consecutive audits before and after implementation of a structured acute pain service were conducted on adult patients, who had undergone major elective abdominal surgery between April,2021-August,2021 (audit A1) and 31st May,2022-31st December,2022 (audit A2). Sources of data were patients’ medical record file and hospital electronic health record. Variables evaluated were patients’ demography, ASA, type and duration of surgery, analgesic modalities, pain scores and complications.
Distribution of patients with dynamic pain on post-operative day 1
Results In our audit, 250 and 683 patients were analysed in A1 and A2 respectively. Notable reduction in severe dynamic pain score was observed in A2 as compared to A1 for both open (31.49% vs 2.4%) and minimally invasive surgeries (34% vs 77%). A decreasing trend of thoracic epidural analgesia was observed ( A1- 80.2% vs A2- 68.49%). A 6.45% decrease in post-operative nausea and vomiting was also observed in A2 ( A1- 22.70% vs A2- 16.25%).
Analgesic modalities in open surgery
Conclusions Introduction of a structured acute pain service resulted in better pain control.
Pain audit IRB letter