Effectiveness of post-operative pain management among patients in a surgical ward at Windhoek central hospital in Namibia
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Date
2022
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
University of Namibia
Abstract
Effective management of post-operative pain improves patient outcomes and quality of life. Although internationally validated pain scales have been implemented for evaluation of post-surgical pain, the majority of patients who undergo surgery in both high-income and low- and middle-income countries continue to experience ineffective management of acute pain. This study aimed to assess effectiveness of post-operative pain management among patients in a surgical ward at Windhoek Central hospital in Namibia by comparing the proportion of patients with moderate to severe pain at 24 h and 48 hours post-operatively. A prospective cohort design was utilized to assess post operative pain at 24 hours and 48 hours using two different pain assessment tools. Data related to prescribing patterns were collected from patient’s clinical records using a standardized data collection tool. Data were analyzed using SPSS v22 software. The study was conducted among 75 participants. Of 75 participants, 48 (64.0%) were males. The mean age was 37.41± 11.13 years. Among the patients involved in the study, 74.7% experienced moderate to severe pain at 24 hours post-operatively which reduced to 41.3% by 48 hours. The difference was statistically significant. Overall, over 5% of the study participants experienced moderate to severe pain at 48 hours post operatively compared to a UK target of less than 5%, showing inadequate management of pain. The cumulative median pain scores for visual analogue scale and numeric pain scale were 5.50 at 24 h and 2.00 at 48 h post-operatively. The difference in median pain scores was statistically significant (p< 0.05). The commonly prescribed analgesics were paracetamol injection (68%), strong opioids (54%) and weak opioids (23%) while adjuvants, and NSAIDs accounted for 8% each, respectively. Out of 75 clinical records reviewed, only 47 (62.7 %) followed WHO guidelines on pain management. There is a need to more frequently assess patient’s level of pain after surgery to ensure effective pain management. In conclusion, post-operative pain is inadequately controlled at WCH.
Description
A mini thesis submitted in partial fulfilment of the requirements for the Degree of Master of Pharmacy (Clinical Pharmacy)
Keywords
Post-operative pain, Effectiveness, Prescribing patterns, Pain scales, Appropriateness