Nursing-led stepwise pain-management protocol improves postoperative outcomes after hepatobiliary surgery

Area of Science:

• Hepatobiliary Surgery
• Pain Management
• Postoperative Recovery

Background:

• Effective postoperative pain management is crucial for patient recovery after hepatobiliary surgery.
• Optimizing pain control can influence complication rates and resource utilization.

Purpose of the Study:

• To evaluate the impact of a stepwise pain-management protocol on postoperative recovery.
• To assess pain control, complication rates, and resource utilization in patients undergoing hepatobiliary surgery.

Main Methods:

• Retrospective cohort study of 222 patients undergoing elective hepatobiliary surgery.
• Comparison between a control group (routine care) and an observation group (stepwise pain-management protocol).
• Primary outcome: postoperative pain intensity (Numerical Rating Scale); Secondary outcomes: gastrointestinal recovery, complications, resource utilization, quality of recovery (QoR-40).

Main Results:

• The protocol group showed significantly lower pain scores (NRS) at all postoperative time points (P < 0.001).
• Faster gastrointestinal recovery, reduced nausea, shorter hospital and ICU stays, and decreased nursing workload were observed (P ≤ 0.001).
• Improved early mobilization, physical function, quality of recovery (QoR-40), and safety, with reduced opioid and patient-controlled analgesia usage (P < 0.001).

Conclusions:

• A stepwise pain management protocol significantly improves perioperative outcomes in hepatobiliary surgery.
• This protocol effectively reduces postoperative pain, accelerates recovery, and decreases complication rates.
• The findings support the implementation of structured pain management strategies for enhanced surgical recovery.