Pre-operative analgesia in the accident and emergency department

To evaluate the adequacy of pre-operative analgesia and patient's satisfaction at the accident and emergency department, in terms of pain relief.

Observational study.

The Accident and Emergency Department (A&E) of Civil Hospital, Karachi, during April and May, 2007.

Patients presenting with acute abdomen or tauma were included. Visual Analogue Scale (VAS) was used to grade severity of pain. Pain at presentation, analgesic prescribed, post-analgesic residual pain and patient satisfaction were assessed.

A total of 166 patients (109 males and 57 females) were enrolled in the study. It included 98 (59%) cases of trauma and 68 (41%) patients with acute abdomen. Mean pain score was 6.95+/-2.03 on VAS. Female patients (p=0.008) and patients with acute abdomen (p<0.001) experienced significantly more pain as compared to male and trauma patients respectively. Analgesics were prescribed to 104 (62.7%) patients. Post-analgesic mean residual pain score was 5.0+/-1.8. Out of them, 47.1% patients waited to be given more analgesia. There was significant less prescription of analgesic to patients with acute abdomen (52.9%) as compared to trauma patients (26.5%) (p=0.001). Overall, more than half of the patients (59.6%) were not satisfied with the pre-operative analgesic treatment in the A&E department.

Pre-operative analgesia was underprescribed and pain was undertreated in accident and emergency department resulting in more than half patients being not satisfied.