Impact of an algorithm-based postoperative pain management in patients undergoing abdominal surgery-A prospective...

The fear of pain is ranked next to the fear of death. Globally, 50% to 75% of postoperative patients experience severe postoperative pain. Pain resource nurses function as role models in pain assessment and management. This study aimed to assess the adequacy of pain management and the effect of algorithm-based postoperative pain management following abdominal surgeries.

A two-phase study was conducted over 6 months in the Surgical Gastroenterology department of a tertiary care center, involving 70 postoperative patients divided equally between the phases using consecutive sampling. The second phase, the primary focus, employed a one-group, post-test-only design, measuring breakthrough pain with the Numerical Rating Scale. Pain management during this phase was guided by a structured, algorithm-based protocol along with standard care. In contrast, the first phase used a quantitative, cross-sectional observational design with patients receiving routine care. Pain severity, quality indicators, and patient satisfaction were assessed using the ASSIST-Patient Satisfaction Survey at multiple points in both phases. This design enabled a systematic comparison between traditional practices and the targeted intervention implemented in Phase II.

The study results showed that more patients in group 1 experienced severe pain at specific times after surgery compared to group 2 (24 hours postsurgery: 52.8 ± 30.2 vs. 27.4 ± 13.7, P = 0.000; 48 hours postsurgery: 34.2 ± 21.5 vs. 29.1 ± 15.6, P = 0.257; 72 hours postsurgery). The patients' satisfaction scores increased after 48 hours postsurgery in group 2 (P < 0.05).

The current study demonstrated that algorithmic pain management can improve the quality indicators of pain management, pain relief, and patient satisfaction scores among postoperative patients.