Bài báo khoa học Tập 65 Số Tiếng Anh 06/12/2024

41. POSTOPERATIVE PAIN MANAGEMENT AND RELATED FACTORS AMONG PATIENTS UNDERGOING ORTHOPEDIC SURGERY: A SINGLE CENTER OBSERVATIONAL STUDY

Pham Duy Quang1, Bui Dinh Hoan2, Le Duc Thang3
1 Nguyen Tat Thanh University
2 University of Medicine and Pharmacy at Ho Chi Minh City
3 Hospital for Traumatology and Orthopaedics at Ho Chi Minh City
Tác giả liên hệ: duyquanghmu@gmail.com
DOI: 10.52163/yhc.v65i13.1882
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Từ khóa
VAS NRS postoperative pain management orthopedic surgery
Tóm tắt

Background: Postoperative inadequate analgesia is common and is associated with poor clinical outcomes. Perioperative pain management after orthopaedics surgery is still challenging. Moreover, the factors associated with severe pain that influence postsurgical pain control according to an acute pain protocol may underestimated and undermanaged, besides in the absence of reports representing Vietnam.

Objective: This study aimed to identify the points pain score via the VAS and perioperative predictors of poor postoperative pain control in patients undergoing orthopaedics surgery.

Method: The cross-sectional study was performed on patients in the Hospital for Traumatology and Orthopaedics HCMC from December 2023 to June 2024.

Results: A total of 615 patients were included in this study. The means of VAS for the before and after orthopaedics surgery were 47.9±19.4 and 40.6±20.9, respectively, with statistically significant differences between the two assessment times (P < 0.05). Spinal surgery (OR = 4.63, 95%CI: 2.53-8.48) and ASA III/IV (OR = 2.78; 95%CI: 1.52-5.10) were statistically associated with severe pain (P < 0.05).

Conclusion: In conclusion, there is an improved significantly between severe pain points by VAS between the first two interviews. Furthermore, we suggest that tightening management patients in ASA III/IV status and providing proper caring based on operative sites are promising approaches to reduce the severe postoperative pain rate.

Tài liệu tham khảo
[1]
Meara JG, Leather AJM, Hagander L, et al. Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development. The Lancet. 2015;386(9993):569-624. doi:10.1016/S0140-6736(15)60160-X Google Scholar
[2]
Erivan R, Chaput T, Villatte G, Ollivier M, Descamps S, Boisgard S. Ten-year epidemiological study in an orthopaedic and trauma surgery centre: Are there risks involved in increasing scheduled arthroplasty volume without increasing resources? Orthopaedics & Traumatology: Surgery & Research. 2018;104(8):1283-1289. doi:10.1016/j.otsr.2018.08.009 Google Scholar
[3]
Gan TJ, Habib AS, Miller TE, White W, Apfelbaum JL. Incidence, patient satisfaction, and perceptions of post-surgical pain: results from a US national survey. Curr Med Res Opin. 2014;30(1):149-160. doi:10.1185/03007995.2013.860019 Google Scholar
[4]
Sommer M, de Rijke JM, van Kleef M, et al. The prevalence of postoperative pain in a sample of 1490 surgical inpatients. Eur J Anaesthesiol. 2008;25(4):267-274. doi:10.1017/S0265021507003031 Google Scholar
[5]
Doyle DJ, Hendrix JM, Garmon EH. American Society of Anesthesiologists Classification. In: StatPearls. StatPearls Publishing; 2023. Accessed November 28, 2023. http://www.ncbi.nlm.nih.gov/books/NBK441940/ Google Scholar
[6]
Price DD, Bush FM, Long S, Harkins SW. A comparison of pain measurement characteristics of mechanical visual analogue and simple numerical rating scales. Pain. 1994;56(2):217-226. doi:10.1016/0304-3959(94)90097-3 Google Scholar
[7]
Breivik H, Borchgrevink PC, Allen SM, et al. Assessment of pain. British Journal of Anaesthesia. 2008;101(1):17-24. doi:10.1093/bja/aen103 Google Scholar
[8]
Mishra BN, Jha A, Gupta Y. Epidemiology of Orthopaedic Admissions at A Teaching Hospital of Eastern Nepal. Journal of Nobel Medical College. 2017;6(1):56-62. doi:10.3126/jonmc.v6i1.18088 Google Scholar
[9]
Chan JJI, Thong SY, Tan MGE. Factors affecting postoperative pain and delay in discharge from the post-anaesthesia care unit: A descriptive correlational study. Proceedings of Singapore Healthcare. 2018;27(2):118-124. doi:10.1177/2010105817738794 Google Scholar
[10]
Zeng Y, Wan J, Ren H, Lu J, Zhong F, Deng S. The influences of anesthesia methods on some complications after orthopedic surgery: a Bayesian network meta-analysis. BMC Anesthesiol. 2019;19(1):49. doi:10.1186/s12871-019-0701-2 Google Scholar
[11]
Myles PS, Myles DB, Galagher W, et al. Measuring acute postoperative pain using the visual analog scale: the minimal clinically important difference and patient acceptable symptom state. Br J Anaesth. 2017;118(3):424-429. doi:10.1093/bja/aew466 Google Scholar
[12]
Chou R, Gordon DB, Leon-Casasola OA de, et al. Management of Postoperative Pain: A Clinical Practice Guideline From the American Pain Society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists’ Committee on Regional Anesthesia, Executive Committee, and Administrative Council. The Journal of Pain. 2016;17(2):131-157. doi:10.1016/j.jpain.2015.12.008 Google Scholar
[13]
Bainbridge D, Martin J, Arango M, Cheng D, Evidence-based Peri-operative Clinical Outcomes Research (EPiCOR) Group. Perioperative and anaesthetic-related mortality in developed and developing countries: a systematic review and meta-analysis. Lancet. 2012;380(9847):1075-1081. doi:10.1016/S0140-6736(12)60990-8 Google Scholar
[14]
Ansell GL, Montgomery JE. Outcome of ASA III patients undergoing day case surgery. British Journal of Anaesthesia. 2004;92(1):71-74. doi:10.1093/bja/aeh012 Google Scholar
[15]
Nielsen KC, Guller U, Steele SM, Klein SM, Greengrass RA, Pietrobon R. Influence of obesity on surgical regional anesthesia in the ambulatory setting: an analysis of 9,038 blocks. Anesthesiology. 2005;102(1):181-187. doi:10.1097/00000542-200501000-00027 Google Scholar