A Descriptive Study of a Perioperative Pain Service Program
Uniformed Services University Of The Health Sciences Bethesda United States
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Postoperative pain remains one of the most common and difficult problems encountered in clinical practice. Pain can affect numerous physiological processes and prolong surgical recovery. This descriptive study was conducted to determine if relationships exist between type of surgery, pain relief and occurrence of side effects. A retrospective chart audit of 133 surgical patients who received coaxial narcotics for pain management was conducted. The sample was obtained from a 155 bed hospital. A description of patients age, gender, type of surgery, type of narcotic infusion, side effects, incidence of breakthrough pain, and treatments were recorded and cross tabulated. The following three surgical categories emerged abdominal, thoracotomy, and orthopedic. Breakthrough pain was reported in 7658.9 cases, of these fifty seven 75 had abdominal surgery,17 22.4 had thoracic surgery, and 2 40 had orthopedic surgery. By surgical category breakthrough pain occurred in 57 of 106 54.8 abdominal cases, 17 of 22 81 of thoracotomies, and 2 of 5 40 of orthopedic cases. Side effects included 64.7 respiratory depression n6. The incidence of nausea and vomiting was comparable within abdominal and thoracotomy cases, 34.9 and 31.8 respectively. Pruritis occurred in 18 17.6 of abdominal cases and 5 22.7 of thoracotomies. Inconsistencies in documentation and noncompliance with written guidelines for patient monitoring was found. Recommendations included further education for nurses in proper and timely documentation and creation of a pain management service team.