Anaesthesiologist-associated risk factors for inadequate postoperative pain management

Liu, YuSheng; Zhao, QingSong; Guo, XiRong; Shen, XiaoFeng; Peng, YuZhu; Xu, ShiQin; Li, XiaoHong; Feng, ShanWu; Wang, FuZhou

doi:10.1016/j.acpain.2009.07.003

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Volume 11, Issue 3 , Pages 83-91, December 2009

Anaesthesiologist-associated risk factors for inadequate postoperative pain management

YuSheng Liu
- Department of Anesthesiology, the Affiliated Nanjing Maternity and Child Health Care Hospital, Nanjing Medical University, No. 123, Tianfei Xiang, Mochou Road, Nanjing 210004, China
- These authors contributed equally to this work.
QingSong Zhao
- Department of Anesthesiology, the Affiliated Nanjing Maternity and Child Health Care Hospital, Nanjing Medical University, No. 123, Tianfei Xiang, Mochou Road, Nanjing 210004, China
- These authors contributed equally to this work.
XiRong Guo
- The Institute of Pediatrics, the Affiliated Nanjing Maternity and Child Health Care Hospital, Nanjing Medical University, Nanjing 210004, China
XiaoFeng Shen
- Department of Anesthesiology, the Affiliated Nanjing Maternity and Child Health Care Hospital, Nanjing Medical University, No. 123, Tianfei Xiang, Mochou Road, Nanjing 210004, China
- Corresponding authors. Tel.: +86 25 84460777 3301; fax: +86 25 84200723.
YuZhu Peng
- The Institute of Pediatrics, the Affiliated Nanjing Maternity and Child Health Care Hospital, Nanjing Medical University, Nanjing 210004, China
ShiQin Xu
- Department of Anesthesiology, the Affiliated Nanjing Maternity and Child Health Care Hospital, Nanjing Medical University, No. 123, Tianfei Xiang, Mochou Road, Nanjing 210004, China
XiaoHong Li
- Department of Anesthesiology, the Affiliated Nanjing Maternity and Child Health Care Hospital, Nanjing Medical University, No. 123, Tianfei Xiang, Mochou Road, Nanjing 210004, China
ShanWu Feng
- Department of Anesthesiology, the Affiliated Nanjing Maternity and Child Health Care Hospital, Nanjing Medical University, No. 123, Tianfei Xiang, Mochou Road, Nanjing 210004, China
FuZhou Wang
- Department of Anesthesiology, the Affiliated Nanjing Maternity and Child Health Care Hospital, Nanjing Medical University, No. 123, Tianfei Xiang, Mochou Road, Nanjing 210004, China
- Corresponding authors. Tel.: +86 25 84460777 3301; fax: +86 25 84200723.

Received 26 March 2009; received in revised form 10 July 2009; accepted 22 July 2009.

Summary

Background

Issues associated with the analgesic failure are major contributors to diminished postoperative health quality. The aim of this survey was to investigate the risk factors associated with anaesthesiologists for inadequate postoperative pain management, i.e. ≥3cm in a 10cm gauge of Visual Analog Scale.

Methods

A total of 1162 confidential questionnaires were sent by mail to anaesthesiologists in clinical hospitals. Information was queried on the incidence of inadequate postoperative pain management with different length of experience in anaesthesia, reasons for such incidence and possible rescue treatments after the occurrence of the incidence, and knowledge in terms of analgesia protocols. Education background and working settings were requested as the contributing factors.

Results

In 813 returned questionnaires, 798 were completed and the data were valid for analysis (68.7% valid response rate). Approximately 43% reported encountered at least one or more incidents of inadequate postoperative analgesia. All positive answers indicated inadequate postoperative analgesia was related to types of surgery. A multiple logistic regression (r²=0.74, P<0.0001) analysis revealed that age, length of anaesthesia experience, education background and work environment are four risk factors in contributing to the incidence. Patient-controlled analgesia is the first choice for postoperative pain therapy, and opioids are preferred as the rescue drugs for inadequate postoperative analgesia.

Conclusions

Inadequate postoperative analgesia occurs widely. Age, length of anaesthesia experience, education background and the working environment of anaesthesiologists are risk factors for inadequate postoperative pain control.

Keywords: Postoperative analgesia, Anaesthesiologist, Therapeutic behaviour, Work experience, Education background