Adults' experiences of perioperative opioid use: a mixed-methods study

Managing acute postoperative pain is challenging because of its subjective nature and factors influencing it.

We explore adults' perioperative pain experiences, focusing on opioid use, shared decision making (SDM), satisfaction, and outcomes to improve patient-centred strategies.

A mixed-methods study included a telephone survey conducted within the first 14 days postsurgery with the International Pain Outcomes (IPO) questionnaire and semi-structured interviews 3 months after surgery. Quantitative and qualitative data were integrated for a comprehensive understanding of pain management experiences.

Of 114 patients, 94% experienced adverse events, mainly anxiety (68%), drowsiness (67%), and helplessness (64%) after surgery. Nearly half (48%) had preoperative persistent pain, with patients spending a median of 40% of their time in severe pain postoperatively and 20% wishing for more pain relief. Despite this, 75% participated in treatment decisions, and satisfaction was high (median 9/10). Analysis of 15 interviews identified 4 themes: nobody is average (unique pain); active partner or passive participant (from empowered to passive, often misinterpreting SDM); working towards a goal (recovery and coping); and pain beyond medicine (emotional, social, spiritual). These findings show pain is highly individual, shaped by involvement and psychosocial factors, and highlight gaps in SDM understanding and use.

Adults' pain management needs holistic, multimodal, individualised approaches with patient input, considering values, goals, and concerns beyond opioids. Clear discharge communication, ongoing care, and provider training are essential for safe recovery. Future research should explore how providers view and use SDM to overcome barriers and improve patient engagement.