Surgeons' attitudes and perception of an acute pain service

To evaluate the attitude and perception of surgeons about postoperative pain management, and an anaesthesiologist-based acute pain service.

Questionnaire survey.

Tertiary university teaching hospital, Hong Kong.

All surgical staff members (specialists and trainees) of the Departments of Surgery, Orthopaedics and Traumatology, and Obstetrics and Gynaecology.

Opinions on postoperative pain management, different pain management modalities, and services provided by the acute pain service.

Of the 147 questionnaires, 104 (71%) were returned. The majority (97%) agreed that effective pain control improves patient recovery and 88% believed that anaesthetists should be involved in postoperative pain management. Overall, 85% of the respondents were satisfied with the acute pain service. However, about one third of them wanted to maintain an active role in postoperative pain management and only 54% thought that the acute pain service has a significant impact on patient outcomes. In addition, only 10% of surgeons agreed that patients receiving acute pain service intervention would be discharged earlier. The respondents also thought that, compared to intravenous patient-controlled analgesia, epidural analgesia required more nursing care and was less cost-effective. Areas of the acute pain service warranting improvement included: education of surgeons on postoperative pain and its management (92%), communication (74%), and referral systems (80%).

The majority of surgeons were satisfied with the acute pain service and agreed that anaesthetists should be involved in postoperative pain management. However, a proportion wanted to maintain an active role in postoperative pain management.