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      Acute postoperative pain experiences and satisfaction with its management among patients with elective surgery: An observational study

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          Abstract

          Background and Aim:

          There is a paucity of regional data on acute postoperative pain. The present study was conducted with an aim to assess the acute postoperative pain experiences, its interference with ADLs, emotions, sleep, IPR and satisfaction with pain management among patients who had undergone elective surgeries.

          Methods:

          In this observational study, 200 postoperative adult patients; who had undergone elective surgery were interviewed using American Pain Society's Patient Outcome and Satisfaction Survey Questionnaire. Pain perception and interference of pain with ADLs, emotions, sleep, and IPR was measured on 0–10 numerical scale and satisfaction on 6 point Likert scale, i.e., very satisfied to very dissatisfied.

          Results:

          There was high incidence (82.5%) of acute postoperative pain experience and mean score for worst episodes of pain was significantly high, i.e., 7.6 ± 1.5, which had significant interference with ADLs (5.6 ± 2.1), sleep (3.6 ± 1.7), and emotions (3.6 ± 1.6). Majority of patients reported that pain was assessed only once (17%) or twice (48.5%) in each shift. Despite of poor pain control, a large number of patients were satisfied with overall pain treatment (69%), and response of physicians (81%) and nurses (62%) for their pain complaints. Acute pain score was directly associated with the duration of postoperative hospital stay ( P = 0.001).

          Conclusion:

          Acute postoperative pain was inadequately assessed and undertreated but still a large number of participants were satisfied with acute postoperative pain management probably because patients expects that pain is inevitable after surgery. Postoperative pain had significant interference with ADLs, emotions and sleep of patients, which may affect postoperative comfort and recovery.

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          Most cited references17

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          Postoperative pain control.

          The effective relief of pain is of the utmost importance to anyone treating patients undergoing surgery. Pain relief has significant physiological benefits; hence, monitoring of pain relief is increasingly becoming an important postoperative quality measure. The goal for postoperative pain management is to reduce or eliminate pain and discomfort with a minimum of side effects. Various agents (opioid vs. nonopioid), routes (oral, intravenous, neuraxial, regional) and modes (patient controlled vs. "as needed") for the treatment of postoperative pain exist. Although traditionally the mainstay of postoperative analgesia is opioid based, increasingly more evidence exists to support a multimodal approach with the intent to reduce opioid side effects (such as nausea and ileus) and improve pain scores. Enhanced recovery protocols to reduce length of stay in colorectal surgery are becoming more prevalent and include multimodal opioid sparing regimens as a critical component. Familiarity with the efficacy of available agents and routes of administration is important to tailor the postoperative regimen to the needs of the individual patient.
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            Pain assessment in the patient unable to self-report: position statement with clinical practice recommendations.

            Individuals who are unable to communicate their pain are at greater risk for under recognition and undertreatment of pain. This position paper describes the magnitude of this issue, defines populations at risk and offers clinical practice recommendations for appropriate pain assessment using a hierarchical framework for assessing pain in those unable to self-report. Nurses have a moral, ethical, and professional obligation to advocate for all individuals in their care, particularly those who are vulnerable and unable to speak for themselves. Just like all other patients, these special populations require consistent, ongoing assessment, appropriate treatment, and evaluation of interventions to insure the best possible pain relief. Because of continued advances and new developments in strategies and tools for assessing pain in these populations, clinicians are encouraged to stay current through regular review of new research and practice recommendations.
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              • Record: found
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              • Article: not found

              How to calculate sample size for observational and experiential nursing research studies?

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                Author and article information

                Journal
                Indian J Anaesth
                Indian J Anaesth
                IJA
                Indian Journal of Anaesthesia
                Wolters Kluwer - Medknow (India )
                0019-5049
                0976-2817
                May 2020
                01 May 2020
                : 64
                : 5
                : 403-408
                Affiliations
                [1]College of Nursing, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
                [1 ]Department of Anaesthesiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
                Author notes
                Address for correspondence: Dr. Suresh K Sharma, College of Nursing, AIIMS, Rishikesh - 249 203, Uttarakhand, India. E-mail: sk.aiims17@ 123456gmail.com
                Article
                IJA-64-403
                10.4103/ija.IJA_33_20
                7286399
                32724249
                bc69e4b2-f3b6-4281-9836-5d052db4212a
                Copyright: © 2020 Indian Journal of Anaesthesia

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                : 19 January 2020
                : 07 March 2020
                : 02 April 2020
                Categories
                Original Article

                Anesthesiology & Pain management
                interference of pain,pain perception,postoperative pain,satisfaction

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