ASSESSING THE ADEQUACY OF PERIOPERATIVE PAIN MANAGEMENT ON IMMEDIATE POST-OPERATIVE ANALGESIA FOR PATIENTS ANESTHETISED UNDER GENERAL ANESTHESIA WHO HAD ELECTIVE INTRAABDOMINAL SURGERYS IN LAUTOKA HOSPITAL, FROM THE 1ST JANUARY 2015- 31ST DECEMBER 2015- A RETROSPECTIVE AUDIT.

Key Words:
Pain management, acute pain, Perioperative period, Analgesia, General Anesthesia, Intra-abdominal Surgery.
Introduction: Perioperative pain is a major problem for patients undergoing surgery. Inadequate pain relief can lead to complications like pneumonia, extended hospital stay, re-admissions and patient dissatisfaction. The aim of this research was to determine adequacy of perioperative pain management on immediate post-operative analgesia for elective Intra-abdominal procedures done under general anesthesia.
Method: This is a retrospective study which involved auditing Inpatient folders from the 1st of January till the 31st of December, 2015.The inclusion criteria were those between the ages of 18 to 60years who had Elective Intra-abdominal procedure done under general anesthesia. Each folder was audited for perioperative pain management from surgical and anaesthetic charts and data were entered into a proforma list. EpiInfo 3.1 software and Microsoft Excel Spreadsheet were used for analysis of the extracted data.
Results: 159 records met the inclusion criteria but only 127 folders were recovered. 28% of patients recorded pain in the immediate postoperative period. There were more females than males and Total Abdominal Hysterectomies was the most common procedure. The age between 31 to 40 years, reported the most pain. Open cholecystectomy’s procedures recorded the most pain complaints and hernia repairs had the least. Verbal response was the highest pain indicator used and 11% of patients who indicated having some pain went from PARU untreated. There were no records of usage of pain scales in any folder retrieved.
Discussion: Pain recording in the recovery unit was heavily dependent on the recovery nurse and the patient. The incidence of immediate postoperative pain from this study group was lower when compared to other studies. This could be due to a lack of documentation or a reflection on how well perioperative pain treatment has been done in Lautoka.
Conclusion: Overall management of perioperative pain still needs improvement. The unaesthetic team should seriously look at this problem as Anesthetist's are still unaware of their patients pain.
Limitations: Missing folders and incomplete anesthesia forms, were a limitation to this Audit.
Recommendations:.
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Highly recommend the formulation of an Acute Pain Management Protocol not only for Lautoka Hospital but for Fiji. Ensure that Pain be included as the 5th vital sign.