Acute postoperative pain in 23 procedures of gynaecological surgery analysed in a prospective open registry study on risk factors and consequences for the patient
Abstract Effective perioperative pain management is essential for optimal patient recovery after surgery and reduces the risk of chronification. However, in clinical practice, perioperative analgesic treatment still needs to be improved and data availability for evidence-based procedure specific ana...
Guardado en:
| Autores principales: | , , , , , , , |
|---|---|
| Formato: | article |
| Lenguaje: | EN |
| Publicado: |
Nature Portfolio
2021
|
| Materias: | |
| Acceso en línea: | https://doaj.org/article/5a9146ddc95f45f1b0d4dd950754626e |
| Etiquetas: |
Agregar Etiqueta
Sin Etiquetas, Sea el primero en etiquetar este registro!
|
| id |
oai:doaj.org-article:5a9146ddc95f45f1b0d4dd950754626e |
|---|---|
| record_format |
dspace |
| spelling |
oai:doaj.org-article:5a9146ddc95f45f1b0d4dd950754626e2021-11-14T12:22:20ZAcute postoperative pain in 23 procedures of gynaecological surgery analysed in a prospective open registry study on risk factors and consequences for the patient10.1038/s41598-021-01597-52045-2322https://doaj.org/article/5a9146ddc95f45f1b0d4dd950754626e2021-11-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-01597-5https://doaj.org/toc/2045-2322Abstract Effective perioperative pain management is essential for optimal patient recovery after surgery and reduces the risk of chronification. However, in clinical practice, perioperative analgesic treatment still needs to be improved and data availability for evidence-based procedure specific analgesic recommendations is insufficient. We aimed to identify procedures related with high pain scores, to evaluate the effect of higher pain intensity on patients and to define patient and intervention related risk factors for increased pain after standard gynaecological and obstetrical surgery. Therefore, we performed a prospective cross-sectional study based on the German registry for quality in postoperative pain (QUIPS). A cohort of 2508 patients receiving surgery between January 2011 and February 2016 in our tertiary referral centre (university departments of gynaecology and obstetrics, respectively) answered a validated pain questionnaire on the first postoperative day. Maximal pain intensity was measured by means of a 11-point numeric rating scale (NRS) and related to procedure, perioperative care as well as patient characteristics. The interventions with the highest reported pain scores were laparoscopic removal of ovarian cysts (NRS of 6.41 ± 2.12) and caesarean section (NRS of 6.98 ± 2.08). Factors associated with higher pain intensity were younger age (OR 1.75, 95% CI 1.65–1.99), chronic pain (OR 2.08, 95% CI 1.65–2.64) and surgery performed outside the regular day shift (OR 1.67, 95% CI 1.09–2.36). Shorter duration of surgery, peridural or local analgesic and preoperative sedation reduced postoperative pain. Patients reporting high pain scores (NRS ≥ 5) showed relevant impairment of daily activities and reduced satisfaction. Caesarean section and minimal invasive procedures were associated with the highest pain scores in the present ranking. Pain management of these procedures has to be reconsidered. Younger age, receiving surgery outside of the regular shifts, chronic pain and the surgical approach itself have a relevant influence on postoperative pain intensity. When reporting pain scores of 5 or more, patients were more likely to have perioperative complications like nausea or vomiting and to be impaired in mobilisation. Registry-based data are useful to identify patients, procedures and critical situations in daily clinical routine, which increase the risk for elevated post-intervention pain. Furthermore, it provides a database for evaluation of new pain management strategies.Jorge Jiménez CruzAngela KatherKristin NicolausMatthias RengsbergerAnke R. MothesEkkehard SchleussnerWinfried MeissnerIngo B. RunnebaumNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-10 (2021) |
| institution |
DOAJ |
| collection |
DOAJ |
| language |
EN |
| topic |
Medicine R Science Q |
| spellingShingle |
Medicine R Science Q Jorge Jiménez Cruz Angela Kather Kristin Nicolaus Matthias Rengsberger Anke R. Mothes Ekkehard Schleussner Winfried Meissner Ingo B. Runnebaum Acute postoperative pain in 23 procedures of gynaecological surgery analysed in a prospective open registry study on risk factors and consequences for the patient |
| description |
Abstract Effective perioperative pain management is essential for optimal patient recovery after surgery and reduces the risk of chronification. However, in clinical practice, perioperative analgesic treatment still needs to be improved and data availability for evidence-based procedure specific analgesic recommendations is insufficient. We aimed to identify procedures related with high pain scores, to evaluate the effect of higher pain intensity on patients and to define patient and intervention related risk factors for increased pain after standard gynaecological and obstetrical surgery. Therefore, we performed a prospective cross-sectional study based on the German registry for quality in postoperative pain (QUIPS). A cohort of 2508 patients receiving surgery between January 2011 and February 2016 in our tertiary referral centre (university departments of gynaecology and obstetrics, respectively) answered a validated pain questionnaire on the first postoperative day. Maximal pain intensity was measured by means of a 11-point numeric rating scale (NRS) and related to procedure, perioperative care as well as patient characteristics. The interventions with the highest reported pain scores were laparoscopic removal of ovarian cysts (NRS of 6.41 ± 2.12) and caesarean section (NRS of 6.98 ± 2.08). Factors associated with higher pain intensity were younger age (OR 1.75, 95% CI 1.65–1.99), chronic pain (OR 2.08, 95% CI 1.65–2.64) and surgery performed outside the regular day shift (OR 1.67, 95% CI 1.09–2.36). Shorter duration of surgery, peridural or local analgesic and preoperative sedation reduced postoperative pain. Patients reporting high pain scores (NRS ≥ 5) showed relevant impairment of daily activities and reduced satisfaction. Caesarean section and minimal invasive procedures were associated with the highest pain scores in the present ranking. Pain management of these procedures has to be reconsidered. Younger age, receiving surgery outside of the regular shifts, chronic pain and the surgical approach itself have a relevant influence on postoperative pain intensity. When reporting pain scores of 5 or more, patients were more likely to have perioperative complications like nausea or vomiting and to be impaired in mobilisation. Registry-based data are useful to identify patients, procedures and critical situations in daily clinical routine, which increase the risk for elevated post-intervention pain. Furthermore, it provides a database for evaluation of new pain management strategies. |
| format |
article |
| author |
Jorge Jiménez Cruz Angela Kather Kristin Nicolaus Matthias Rengsberger Anke R. Mothes Ekkehard Schleussner Winfried Meissner Ingo B. Runnebaum |
| author_facet |
Jorge Jiménez Cruz Angela Kather Kristin Nicolaus Matthias Rengsberger Anke R. Mothes Ekkehard Schleussner Winfried Meissner Ingo B. Runnebaum |
| author_sort |
Jorge Jiménez Cruz |
| title |
Acute postoperative pain in 23 procedures of gynaecological surgery analysed in a prospective open registry study on risk factors and consequences for the patient |
| title_short |
Acute postoperative pain in 23 procedures of gynaecological surgery analysed in a prospective open registry study on risk factors and consequences for the patient |
| title_full |
Acute postoperative pain in 23 procedures of gynaecological surgery analysed in a prospective open registry study on risk factors and consequences for the patient |
| title_fullStr |
Acute postoperative pain in 23 procedures of gynaecological surgery analysed in a prospective open registry study on risk factors and consequences for the patient |
| title_full_unstemmed |
Acute postoperative pain in 23 procedures of gynaecological surgery analysed in a prospective open registry study on risk factors and consequences for the patient |
| title_sort |
acute postoperative pain in 23 procedures of gynaecological surgery analysed in a prospective open registry study on risk factors and consequences for the patient |
| publisher |
Nature Portfolio |
| publishDate |
2021 |
| url |
https://doaj.org/article/5a9146ddc95f45f1b0d4dd950754626e |
| work_keys_str_mv |
AT jorgejimenezcruz acutepostoperativepainin23proceduresofgynaecologicalsurgeryanalysedinaprospectiveopenregistrystudyonriskfactorsandconsequencesforthepatient AT angelakather acutepostoperativepainin23proceduresofgynaecologicalsurgeryanalysedinaprospectiveopenregistrystudyonriskfactorsandconsequencesforthepatient AT kristinnicolaus acutepostoperativepainin23proceduresofgynaecologicalsurgeryanalysedinaprospectiveopenregistrystudyonriskfactorsandconsequencesforthepatient AT matthiasrengsberger acutepostoperativepainin23proceduresofgynaecologicalsurgeryanalysedinaprospectiveopenregistrystudyonriskfactorsandconsequencesforthepatient AT ankermothes acutepostoperativepainin23proceduresofgynaecologicalsurgeryanalysedinaprospectiveopenregistrystudyonriskfactorsandconsequencesforthepatient AT ekkehardschleussner acutepostoperativepainin23proceduresofgynaecologicalsurgeryanalysedinaprospectiveopenregistrystudyonriskfactorsandconsequencesforthepatient AT winfriedmeissner acutepostoperativepainin23proceduresofgynaecologicalsurgeryanalysedinaprospectiveopenregistrystudyonriskfactorsandconsequencesforthepatient AT ingobrunnebaum acutepostoperativepainin23proceduresofgynaecologicalsurgeryanalysedinaprospectiveopenregistrystudyonriskfactorsandconsequencesforthepatient |
| _version_ |
1718429227539234816 |