Federico Sertic, MD, Ashwin Gojanur, Dr, Ahmed Hammad, MD. Guy’s and St Thomas’ Hospital
Introduction: The aim of this project is to assess the quality of post-operative pain relief in colorectal surgery and identify patients in whom pain management has not been effective, in order to improve the quality of post-operative care.
Effective management of post-operative pain has long been recognised as important in improving the post-operative experience, reducing complications and promoting early discharge from hospital.
Standards: all patients should be pain free at rest, 100% of elective patients should be told about what analgesia they will have post-operatively, 100% of patients should be satisfied with their pain management and 100% of patients should feel staff did everything they could to control their pain.
Methods and procedures: Questionnaires were given to 20 patients on the day prior to discharge. 13 questions about pre-operative and post-operative pain experience were asked.
Data regarding post-operative analgesia were collected from medication charts and medical notes.
Data were collected over a period of two months (August/September 2017).
Range of procedures: 4 elective laparoscopic abdomino-perineal-excision-of-rectum with IGAP flaps, 1 elective laparoscopic right hemicholectomy, 7 laparotomy + bowel resection/stoma formation (5 elective, 2 emergency), 1 elective repair of parastomal hernia, 5 appendicectomy (2 laparoscopic elective, 2 laparoscopic emergency, 1 laparotomy emergency) and 2 elective reversal of ileosomy.
Pain scores (1-10): Immediately post-operative pain, day 1 post-operative pain, post-operative pain after day 1 and pain on moving/coughing/straining.
Results: Mean immediate post-operative pain score was 4.0 (10% of patients with score 8+), mean day 1 post-operative pain score was 4.8, mean post-operative pain score after day 1 was 4.25, mean pain score on moving was 6.2 (30% of patients with score 8+), mean pain score on coughing/straining was 6.8 (30% of patients with score 8+).
90% of patients were satisfied with their post-operative pain management and felt that the staff had done everything they could to manage their pain.
25 % of patients were not aware of their post-operative analgesia regimen and 50% did not know how regularly they could request analgesia.
Conclusions: Effective management of post-operative pain is a key part of post-operative care and an important component of enhanced recovery programmes.
Patient satisfaction with pain management has been found to correlate with received pre-operative information.
Increasing ward nurses’ and acute pain teams’ knowledge is important in improving patients’ pain experiences.
Interestingly, those patients who had a background of long-term opioid requirements reported that they were satisfied with their pain management.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 86871
Program Number: P358
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster