Pain control in the immediate postoperative period and analysis of the prescription of analgesics

Abstract

Background: Postoperative pain is most frecuently intense and opiate analgesics are needful to relieve it. In our country, incidence ofthis symptom and usual management remaind unkown. We attempt to evaluate the acute pain relief after open abdominal surgery and the prescription models for morphine.

Methods: This was an observational study during the first 24 hours of postoperative time. We included 3 1 male and 56 women (15 - 87 years); we did an indication-prescriptions analysis and interview for verbal rating scale of pain in the clinical setting.

Results: At interview, 80.5% related to have pain (38,5% moderate pain and 18.6% intense or unbearable) although 50,0 ofthese received one analgesic dose during previous 3 hours. In previous hours 90.8% had pain (73.4% moderate or most severe pain). Morphine was prescribed to 58.8% of patients, 27.4% as single analgesic and 37.3% with tramadol. This drug was prescribed as "by necessary reason" in 29.4% of cases (a half without defined interval), 58.8% with dosification interval greater to 6 hours, and 35.3% have dose of7.5 mg. One first dose was administrated to 59.9%. Morphine was not prescribed in 41.4% ofthe patients (they received tramadol and/or diclofenaco).

Conclusions: Partial and insufficient relieve of postoperativ pain is achieved even though potent analgesics are available. Morphine was poorly employed and posology didn 't show a rational prescription. The hospital use of analgesics doesn't traduce an optimal relieve to acute pain during immediate postoperative time.