Survey of Postoperative Pain Management Orders at Srinagarind Hospital

Abstract

Background : Inappropriate medications, or doses, routs and duration of appropriate medications for control of acute postoperative pain have both physical and psychological sequelae.

Objective : To survey the orders given over the first 24 hours for postoperative pain control at Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Thailand.

Methods: cross-sectional descriptive study.

Setting: Post Anesthesia Care Unit (PACU), Srinagarind Hosptial

Materials and Methods: We inventoried the orders given for the first 24 hours of postopetrative pain control for patients admintted to PACU between June 21 and 22, 2001.  Excluded were patients transferred to ICU postoperatively, outpatients and those given anesthesia by local infiltration.

Results: 225 patients were admitted to PACU during the sampling period.  The types of pain control medication given included : Tramadol 37.4%, Pethidine 29.6% Paracetamol 22.3%, Morphine 10.2%,and Fentanyl 0.5% No jpain treatment was ordered in 8.4% of the cases.  The predominant pain control orders from the Department of Surgery was Pethidine 46.4% from Orthopedics, Tramadol Tramadol 76.6%, from ENT, Paracetamol 46.4%,  form OB-GYN, Pethidine Pethidine 67.6%, from Ophthalmology, Paracetamol 100%, and from Dentistry, Pethidine (100%). The most common administration routes ordered were: intravenous by the Department of Surgery (82%), intramuscular by Orthopedics (63.6%), intravenous by ENT (48%), intramuscular by OB-GYN (91%), oral by Ophthalmology (100%), and intramuscular by Dentistyr (100%). Differences in dose and duration of administration occurred when both appropriate and inappropriate orders were given.

Conclusion: The postoperative pain orders at Srinagarind Hospital have many differences in medications, doses, and duration.  It was up to level of pain and many factors in individual patients.  This research was designed for survey of the basic information and for development of next research.

Keyword: 1. Postoperative pain 2. Doctor’s order 3. Analgesic drugs