Surgeon Perceptions and Experiences with Postoperative Acute Pain Management: A Mixed-Methods Study

Although prior studies have examined healthcare providers' perspectives on opioid prescribing for postoperative pain, limited research exists on surgeons' experiences managing acute postoperative pain in adults. This study evaluated surgeons' perceptions and experiences to better understand challenges in managing acute pain and assess perceived impacts of inadequately managed pain on patients.

A sequential mixed methods study was conducted using concept elicitation interviews and a descriptive quantitative survey, with a convenience sample of United States (US)-based general, orthopedic, and plastic surgeons. Interview findings identified key themes related to surgeons' perceptions of challenges and barriers associated with managing postoperative acute pain. These themes informed the development of a survey to quantify surgeons' unmet needs, challenges, and experiences regarding postoperative pain management.

Key themes from the interviews (N = 30) included challenges with effective pain management, advantages and disadvantages of commonly used pain medications, and difficulties managing pain in special populations. Among surveyed surgeons (N = 80), the most frequently reported challenges were managing patient pain management expectations (72.5%) and balancing adequate analgesic effect with risk of adverse events (71.3%). Approximately half (53.8%) were "moderately satisfied" with pain medications available during the study period, identifying the most important medication characteristics as the degree and duration of analgesic effect and time to onset. Most surgeons (80.0%) reported that concerns about opioid addiction or dependency "moderately" to "extremely impacted" their prescribing patterns. Additionally, 65% of surgeons indicated that inadequately managed postoperative pain has a moderate to extreme impact on patient recovery.

Surgeon experiences with postoperative pain management emphasize challenges and unmet needs surrounding acute pain medications and highlight surgeons' perceptions of the negative impacts of inadequately managed acute pain on patients.