STATUS OF PERIOPERATIVE TREATMENT OF PAIN IN GERMANY - RESULTS OF A REPRESENTATIVE AND ANONYMOUS SURVEY OF 1,000 SURGICAL CLINICS

To evaluate the status of perioperative pain management we mailed a an onymous postal survey to all 2,254 surgical departments in Germany. We received answers from 1,000 clinics (44.4%) which were representative related to their regional distribution. We asked the responsible surg eons to report their organizational structure and responsibilities for treating pain patients, the significance of the problem, their method s of measuring pain, and the usage of different analgesic drugs and me thods. In 47% the surgeon and the anesthesist together had responsibil ity for adequate postoperative pain treatment; in 33% and 14%, respect ively, it was the surgeon and anesthesist alone. Only 41% knew the int erdisciplinary statement on pain therapy of the Professional Societies of German Surgeons and Anaesthesists from 1992. Although the importan ce of postoperative pain is globally acknowledged, only 19.1% of all d epartments had a written concept for pain treatment. Pain was measured in only 11% of the clinics mainly by using the visual analogue scale. Most surgeons relieve pain solely with systemic drugs. Regional analg esia was used by 18% only. 51% of the surgeons decide on the choice an d dosage of analgesic therapy on the ward; 33% admit that pain therapy often starts after complaints of the patient. 70% of all surgeons nev er participated in a congress on pain. We conclude that postoperative pain management in most German surgical departments still lacks effect iveness, adequacy, and organizational and scientific background.