MANAGEMENT OF POSTOPERATIVE PAIN - AN INTERVENTION STUDY

Background: In 1989 a study had shown that the quality of postoperativ e pain treatment (PPT) in a district general hospital was not satisfac tory. Therefore, new instructions for PPT were issued, intra-venous me dication with morphine was introduced on the wards, and the staff was educated in PPT. The purpose of this study was to investigate the qual ity of PPT in 1992 compared to the quality in 1989. Methods: Using ide ntical questionnaires, 191 patients in 1989 and 126 patients in 1992 w ere interviewed before and 2-5 days after surgery regarding postoperat ive pain. At the postoperative interview patients in pain also filled out the McGill Pain Questionnaire. A questionnaire was also answered b y the nurses regarding PPT in 1989 and in 1992. Results: 1992 compared to 1989 (1992/1989): all patients were now medicated (100%/93%), most of them regularly (79%/4%) and the majority (94%/15%) also received n on-opioid analgesic. Fewer patients (65%180%) experienced postoperativ e pain lasting more than one day following surgery. Analgesic prescrip tion was more standardized. In 1992 the nurses were more satisfied tha n in 1989 with the PPT and the physicians' prescribing patterns. All t he above-mentioned parameters were significantly improved from 1989 to 1992. All the different pain-scares showed a reduction (8-30%) but di d not reach statistical significance (P=0.2). Conclusions: Our two inv estigations show that it is possible to improve the quality of pain ma nagement with rather simple reforms.