Postoperative Pain Management and Patient Satisfaction in an Indian Tertiary Care Centre-A Prospective Observational Study

Abstract

Introduction: Despite various advancements over last two decades in pain medicine, post-operative pain remains inadequately addressed, even in a tertiary medical center. There are very limited studies addressing post-operative pain management in India. Few published studies have assessed post-operative pain, but only at 24 hours intervals, and utilising tools focusing on any one parameter of pain. Hence, a holistic assessment using four different pain assessment tools should be done to get a wider overview of the condition. Aim: To assess the intensity and severity of post-operative pain at 6, 12, 24 & 48 hours postoperatively for patients undergoing surgery for orthopaedics, gastrointestinal, general surgery, obstetrics & gynaecological ailments and patient satisfaction at 24 hours postoperatively. Materials and Methods: A prospective observational survey was conducted at a tertiary care centre of New Delhi from October 2020 to October 2021. Three scales were used to determine the status of post-operative pain at 6,12,24 and 48 hours follow-up. The three different pain scales were Numerical Pain Rating Scale (NRS-pain) static and dynamic, Global Perceived Effect (GPE) and Neuropathic Pain System Inventory (NPSI). Results: Total of 400 patients, with mean age of the study population was 43.26±4.98 years. Majority were males, 250 (60%) and of ASA Grade I, 208 (52%). Significant improvement was observed in the NRS pain score at each follow-up among those undergoing orthopaedic surgery, general surgery, and gynaecological procedures. Improvement in the mean GPE scale was only seen for orthopaedic surgeries. There was a significant neuropathic pain component observed in all the surgeries except gynaecological surgeries. Majority 321 (80.25%) had received information about their pain treatment but only 174 (43.5%) were satisfied with their pain treatment. Conclusion: A majority of the patients undergoing orthopaedic or general surgery, and gynaecological procedures had improvement in pain. This survey highlights the need for investigating future post-operative pain management protocols so that the intensity of post-operative pain, incidence of chronic persistent pain & resulting suffering, as well as disability, can be minimised to a large extent.

Keywords

• global perceived effect
• numerical pain rating scale
• neuropathic pain system inventory