Postoperative pain at Landspitali: A prospective study

Area of Science:

• Anesthesiology and Pain Management
• Surgical Outcomes Research
• Patient Safety

Background:

• Moderate to severe postoperative pain remains a significant challenge despite advancements in surgical and analgesic techniques.
• Assessing the prevalence and severity of pain after anesthesia is crucial for improving patient care.

Purpose of the Study:

• To determine the incidence and intensity of postoperative pain following surgical procedures requiring anesthesia.
• To identify patient-specific and procedure-related factors associated with an increased risk of postoperative pain.

Main Methods:

• Prospective questioning of 438 adult surgical patients on pain levels using a numerical rating scale (NRS) in the post-anesthesia care unit (PACU) and within 24 hours postoperatively.
• Collection of clinical data from medical records.
• Multivariable logistic regression analysis to identify predictors of moderate/severe worst pain (NRS ≥ 5) on postoperative day one.

Main Results:

• 29% of patients experienced moderate/severe pain on the day of surgery, rising to 70% for worst pain on postoperative day one.
• Factors increasing the odds of moderate/severe pain included female sex, chronic preoperative pain, major procedures, and intraoperative remifentanil use.
• Increased age and specific surgeries (breast, gynecology, otolaryngology, neurosurgery) were associated with lower odds of moderate/severe pain.

Conclusions:

• The high proportion of patients reporting severe worst pain on postoperative day one indicates a need for improved pain management strategies.
• Identifying patients and procedures at higher risk for severe postoperative pain allows for targeted interventions and enhanced perioperative monitoring.