PATIENT EXPERIENCE OF PAIN AFTER ELECTIVE NONCARDIAC SURGERY

The purpose of this study was to examine the extent and evolution of p ain after common major surgical procedures and to establish correlates of three types of pain: pain at rest, pain with movement, and maximum pain over the previous 24 h. Patients completed a preoperative questi onnaire to obtain data on age, gender, narcotic use, baseline level of pain, chronicity of pain, and level of anxiety. Patients were then in terviewed on Postoperative Days 1, 2, and 3 to assess their pain on a scale of 0 (none) to 10 (worst imaginable). The mean pain score at res t was 2.6 on Postoperative Day 1 and decreased to 2.3 on Postoperative Day 3 (P = 0.06). The mean pain score with movement was 4.5 on Postop erative Day 1, which decreased to 4.2 on Postoperative Day 3 (P = 0.03 ). The mean maximum pain score over the previous 24 h was 6.3, which d ecreased to 5.6 (P = 0.0001). Preoperative narcotic use and high basel ine preoperative pain, defined as a score greater than or equal to 4, were significantly (P < 0.05) associated with increased pain at rest, pain with movement, and maximum pain. Epidural analgesia was the only mode of analgesia significantly associated with both decreased postope rative pain at rest and decreased pain with movement (P < 0.05). These relatively high pain scores and minimum decreases in pain from Postop erative Days 1 to 3 emphasizes the need for more effective pain manage ment continuing into the postoperative period to facilitate mobilizati on and recovery.