The quality and continuity of systemic postoperative analgesia: a single center two-stage follow-up study
1Department of Anaesthesiology, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania
2Department of Anaesthesiology, Hospital of Lithuanian University of Health Sciences Kaunas Clinics, 50161 Kaunas, Lithuania
3Medical Academy, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania
4Department of Intensive Care, Kaunas Hospital of the Lithuanian University of Health Sciences, 45130 Kaunas, Lithuania
5Department of ENT Surgery, Medical Academy, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania
DOI: 10.22514/sv.2022.068 Vol.19,Issue 3,May 2023 pp.74-83
Submitted: 11 March 2022 Accepted: 29 April 2022
Published: 08 May 2023
*Corresponding Author(s): Jurate Gudaityte E-mail: email@example.com
The aim of two prospective 1-month follow-up studies was to assess and compare the quality and continuity of postoperative systemic analgesia in Departments of Anaesthesiology and Surgery I and II, as well as adherence to prescribed plan of analgesia with respect to the effect of postoperative analgesia guidelines adopted in 2018. The studies included 94 (2016) and 80 (2018) patients who were operated under general anaesthesia, transferred to post-anaesthetic care unit (PACU), then to surgical wards and received systemic analgesia postoperatively. Comparison was based on adherence to postoperative analgesia plan during patient transfer. Recommendations for multimodal postoperative analgesia were given by the anaesthesiologist in 35.1% (ketoprofen + opioid) and 40.4% (paracetamol + opioid) in 2016 vs. 91.3% of cases in 2018, p < 0.001. Comparing 2016 to 2018, adherence to planned analgesia in PACU, % of cases was 35.1% vs. 92.5% for paracetamol (p < 0.001), 30.9% vs. 80% for ketoprofen (p < 0.001) and 75.5% vs. 72.5% for pethidine (p = 0.649). Adherence to planned analgesia after transfer to Department of Surgery I, % of cases was 3.3% vs. 80% for paracetamol (p < 0.001), 1.7% vs. 22% for ketoprofen (p < 0.001) and 61.7% vs. 20% for pethidine (p < 0.001). Adherence to planned analgesia after transfer to Department of Surgery II, % of cases was 0% vs. 10% for paracetamol (p = 0.059), 61.8% vs. 73.3% for ketoprofen (p = 0.325) and 29.4% vs. 13.3% for pethidine (p = 0.12), respectively. In conclusion, patients receive recommended systemic analgesia in PACU. Implementation of guidelines in Department of Surgery I resulted in 42% reduction of opioid and 76%increase of paracetamol use. Adherence to recommended analgesia in Department of Surgery II remains low.
Postoperative; Analgesia; Surgery; Guidelines; Audit; Follow-up
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