Background Acute and persistent pain after surgery is well described. However, no large-scale studies on immediate postoperative pain in the operating room (OR) exist, hindering potential areas of research to improve clinical outcomes. Thus, we aimed to describe the occurrence and severity of immediate postoperative pain in a large, unselected cohort.
Methods This was a prospective cohort study, encompassing all procedures in 31 public hospitals in the Danish Realm, during a 5-day period including the weekend. Data on procedures and anesthesia were collected and the main outcome was occurrence of moderate or severe pain in the OR. Secondary outcomes included pain, sedation and nausea in the OR or during the first 15 min in the postanesthesia care unit (PACU) including relevant risk factors. Descriptive and logistic regression statistics were used.
Results A total of 3675 procedures were included for analysis (87% inclusion rate). Moderate or severe pain occurred in 7.4% (95% CI 6.5% to 8.3%) of cases in the OR immediately after awakening, rising to 20.2% in the OR and/or PACU. Large intraprocedure and interprocedure variations occurred (0.0%–37.5%), and in 20% of cases with epidural-general anesthesia patients experienced moderate or severe pain. Independent risk factors were female sex, younger age, preoperative pain, daily opioid use and major surgical procedures.
Conclusion Moderate or severe pain in the immediate postoperative phase occurred in 20% of all cases with procedure and anesthesiological technique variations, suggesting a need for identification of relevant procedure-specific risk factors and development of preventive treatments.
Trial registration number RoPR ID 43191.
- acute pain
- pain management
Data availability statement
Data are available upon reasonable request. Data are available upon request from the corresponding author, after consideration by the research consortium, of the research protocol that must be sent along with the request.
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Correction notice This article has been corrected since it published Online First. The first affiliation has been corrected.
Collaborators Laurits Elgaard, Department of Anaesthesiology, Centre of Head and Orthopaedics, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark; Bettina Nygaard Nielsen, Department of Anaesthesiology, Juliane Marie Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark; Mie Heerwagen Hagerup, Department of Anaesthesiology and Intensive Care, Neuroanesthesiology, Copenhagen University Hospital, Rigshospitalet, Denmark.
Contributors All authors participated in the protocol design and approval, data collection and manuscript revisions. AMR, MHT, and EKA drafted the protocol. AMR, MHT, EKA, and HNA analyzed the data and the first version of the manuscript. EKA conceptualized the study.
Funding The study was supported by an unrestricted €2.500 grant from Norpharma for data entry. All other expenses related to the study were covered by the participating departments.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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