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2019, Number 3

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Rev Mex Anest 2019; 42 (3)

What can be done to improve management of perioperative pain?

Zaslansky R, Chapman R, Meissner W

Language: Spanish
References: 22
Page: 149-152
PDF size: 111.39 Kb.


Text Extraction

Approximately 232 million patients undergo major surgery worldwide, each year and up to 80% of these patients will report pain of an intensity that is moderate to severe. Specifically, approximately 185 million will people endure pain that will persist for days to weeks and months after surgery. Severe post-operative pain is not innocuous, it has documented harmful effects on short and long term recovery, affecting patients and sometimes also their families. As an example, after Caesarean Delivery, women with severe pain have a 2.5 to 3 fold increased risk of developing postpartum depression and persistent pain 8 weeks after surgery. This in turn, may have a negative effect on the cognitive development of infants born to these mothers. Pain degrades patient and family quality of life, increases health care utilization, and so drives up associated costs. Severe pain is one of the most consistent risk factors for developing chronic post-surgical pain, occurring in 10% up to 50% of patients after surgery. Of the known risk factors, pain is possibly one of the few factors that can be modified by healthcare providers. The literature describes large variability in patient care, an indicator of poor practice. These findings are well documented for patients in high resource countries, such as the United States and in Europe. Garcia et al have written a comprehensive review about findings in Latin America, indicating that problems are similar to those found in other countries.


REFERENCES

  1. Weiser TG, Regenbogen SE, Thompson KD, Haynes AB, Lipsitz SR, Berry WR. An estimation of the global volume of surgery: a modelling strategy based on available data. Lancet. 2008;372:139-144.

  2. Gan TJ. Poorly controlled postoperative pain: prevalence, consequences, and prevention. J Pain Res. 2017;10:2287-2298.

  3. Eisenach JC, Pan PH, Smiley R, Lavand’homme P, Landau R, Houle TT. Severity of acute pain after childbirth, but not type of delivery, predicts persistent pain and postpartum depression. Pain. 2008;140:87-94.

  4. Wilson AC, Fales J. Parenting in the context of chronic pain: a controlled study of parents with chronic pain. Clin J Pain. 2015;31:689-698.

  5. Taylor RS, Ullrich K, Regan S, Broussard C, Schwenkglenks M, Taylor RJ, et al. PAIN-OUT investigators the impact of early post operative pain on health-related quality of life. Pain Pract. 2012;13:515-523.

  6. Kehlet H, Jensen TS, Woolf CJ. Persistent postsurgical pain: risk factors and prevention. Lancet. 2006;13:1618-1625.

  7. Meissner W, Coluzzi F, Fletcher D, Huygen F, Morlion B, Neugebauer E, et al. Improving the management of post-operative acute pain: priorities for change. Curr Med Res Opin. 2015;31:2131-2143.

  8. Tomson CR, van der Veer SN. Learning from practice variation to improve the quality of care. Clin Med (Lond). 2013;13:19-23.

  9. Benhamou D, Berti M, Brodner G, De Andres J, Draisci G, Moreno-Azcoita M, et al. Postoperative analgesic therapy observational survey (PATHOS): a practice pattern study in 7 central/southern European countries. Pain. 2008;136:134-141.

  10. Garcia JBS, Bonilla P, Kraychettec DC, Flores FC, de Valtolina EDP, Guerrero C. Optimizing post-operative pain management in Latin America. Rev Bras Anestesiol. 2017. http://dx.doi.org/10.1016/j.bjane.2016.04.003.

  11. Gliklich R, Dreyer N, Leavy M, eds. Registries for evaluating patient outcomes: a user’s guide. 3rd edition. Rockville, MD: Agency for Healthcare Research and Quality; 2014. [Accessed May 2019] Available in: http://www.effectivehealthcare.ahrq.gov/registries-guide-3.cfm.

  12. Schouten LM, Hulscher ME, van Everdingen JJ, Huijsman R, Grol RP. Evidence for the impact of quality improvement collaboratives: systematic review. BMJ. 2008;336:1491-1494.

  13. Gordon D, Zaslanksy R, Meissner W. Overview of systems design and quality improvement to improve outcomes and identify best practices. In: Carr DB, Arendt-Nielsen L, Vissers KCP, (eds). Pain after surgery. IASP Press; 2018.

  14. Rothaug J, Zaslansky R, Schwenkglenks M, Komann M, Allvin R, Backström R, et al. Patients’ perception of post-operative pain management: Validation of the International Pain Outcomes questionnaire (IPO). J of Pain. 2013;14:1361-1370.

  15. Ivers NM, Sales A, Colquhoun H, Michie S, Foy R, Francis JJ, et al. No more ‘business as usual’ with audit and feedback interventions: towards an agenda for a reinvigorated intervention. Implement Sci. 2014;9:14.

  16. Schwenkglenks M, Gerbershagen HJ, Taylor RS, Pogatzki-Zahn E, Komann M, Rothaug J, et al. Correlates of satisfaction with pain treatment in the acute postoperative period: results from the international PAIN OUT registry. Pain. 2014;155:1401-1411.

  17. Gerbershagen HJ, Aduckathil S, van Wijck AJ, Peelen LM, Kalkman CJ, Meissner W. Pain intensity on the first day after surgery: a prospective cohort study comparing 179 surgical procedures. Anesthesiology. 2013;118:934-944.

  18. Fletcher D, Stamer UM, Pogatzki-Zahn E, Zaslansky R, Tanase NV, Perruchoud C, et al. Chronic postsurgical pain in Europe: an observational study. Eur J Anaesthesiol. 2015;32:725-734.

  19. Zaslansky R, Chapman CR, Baumbach P, Bytyqi A, Castro-Lopes JM, Chetty S, et al. Improving perioperative pain management: a preintervention and postintervention study in 7 developing countries. Pain Rep. 2019;25:4:e705.

  20. Chou R, Gordon DB, de Leon-Casasola OA, Rosenberg JM, Bickler S, Brennan T, 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. J Pain. 2016;17:131-157.

  21. Schug SA, Palmer GM, Scott DA, Halliwell R, Trinca J; APM:SE Working Group of the Australian and New Zealand College of Anaesthetists and Faculty of Pain Medicine. Acute pain management: scientific evidence. 4th edition. Melbourne: ANZCA & FPM; 2015.

  22. PROSPECT Procedure Specific Post-Operative Pain Management. Available in: https://esraeurope.org/prospect/




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