Acute Postoperative Pain Prevalence and Intensity in the First 72 Hours

Acute Postoperative Pain Prevalence and Intensity in the First 72 Hours in Dessie Referral Hospital, Ethiopia: a Prospective Single-center Cohort Study

Postoperative pain is poorly studied in developing countries. Severe pain after surgery remains a major problem, occurring in 50% to 70% of the patients. Differences exist across countries. Despite numerous published studies, the degree of pain following many types of surgery in everyday clinical practice is unknown. To improve postoperative pain treatment and develop procedure-specific, optimized pain-treatment protocols, the prevalence and severity of postoperative pain must first be identified.

This study aimed to determine the incidence and intensity of acute postoperative pain, to identify populations associated with a higher risk in order to guide resource allocation, and to investigate whether inexpensive analgesic modalities are currently utilized maximally.

Study Overview

• Status: Completed
• Conditions: Post Operative Pain
• Intervention / Treatment: Procedure: surgery

Detailed Description

Postoperative pain management remains one of the major challenges in the care of surgical patients in many parts of the world. Despite improved care, studies show that postoperative pain continues to be inadequately treated and that patients still suffer moderate to severe pain after surgery. Despite an improved understanding of pain mechanisms, several risk factors, and advances in pain management strategies, postoperative pain continues to be a widespread and unresolved problem.

In Ethiopia, pain management is done in the traditional way, and pain control regimens vary from center to center and again from person to person in the same center due to a lack of pain management protocol. Overall pain management criteria used are not clear and sometimes decisions may be influenced by what is available in stock. Therefore, this research on the assessment of postoperative pain management provides information for clinicians to formulate protocols for the management of postoperative pain and for hospital managers in order to guide resource allocation to use limited resources efficiently and plan for optimum postoperative pain management.

In the study, the investigators used a numerical pain rating scale for pain immediately after surgery for the first 72 hours after surgery. The prevalence of mild, moderate, or severe pain and median pain scores were calculated. An evaluation will be performed at eight time points: at T2, T4, T8, T12, T24, T48, and T72. They consider 350 patients from all surgical wards. All surgical procedures were assigned to 5 well-defined groups. When a group contained less than 20 patients the data was excluded from the analysis.

• Study Type: Observational
• Enrollment (Actual): 350

Contacts and Locations

Study Locations

• Ethiopia
  • Dessie, Ethiopia, 1145
    • Wollo Univeersity

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Probability Sample

Study Population

All eligible patients who will be undergo elective major abdominal, gynecologic, urologic, obstetric and orthopedic surgeries at Dessie comprehensive specialized hospital in the course of study period

Description

Inclusion Criteria:

• Age ≥18 years old
• Able to provide informed consent
• Able to verbalize or indicate pain by using a traditional verbal scale such as the numeric rating scale at the 2nd hr. of Post anesthesia care unit arrival.

Exclusion Criteria:

• Patients unable to self-report acute pain
• Patients with a history of chronic pain, moderate to high acute pain previous to surgery.
• Patients with a previous diagnosis of chronic cognitive impairment (Dementia, Alzheimer …)
• Patients with a previous diagnosis of Neurologic impairment (paraplegia, q quadriplegia…)
• The patients excluded from the study will be patients with mental and psychological problems.

Study Plan

How is the study designed?

Number of groups / cohorts

5

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
T2 hour	Procedure: surgery; Surgical procedures performed in the study period
T12 hour	Procedure: surgery; Surgical procedures performed in the study period
T24 hour	Procedure: surgery; Surgical procedures performed in the study period
T48 hour	Procedure: surgery; Surgical procedures performed in the study period
T72 hour	Procedure: surgery; Surgical procedures performed in the study period

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Prevalence of postoperative pain in the first 72 hrs	prevalence of postoperative pain , at 2nd, 4th, 8th, 12th, 24th, 48th and 72nd hr.	72 hours

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Intensity of postoperative pain in the first 72 hrs.	The intensity of postoperative pain in the first 72 hours assessed with numeric rating scale. NRS 1-3 mild pain, 4-6 moderate pain, 7-10 severe pain.	72 hours

Collaborators and Investigators

• Sponsor: Wollo University
• Investigators: Principal Investigator: Sara Timerga, Wollo University

Study record dates

Study Major Dates

• Study Start (Actual): September 1, 2022
• Primary Completion (Actual): January 30, 2023
• Study Completion (Actual): July 30, 2023

Study Registration Dates

• First Submitted: August 1, 2023
• First Submitted That Met QC Criteria: September 29, 2023
• First Posted (Actual): October 4, 2023

Study Record Updates

• Last Update Posted (Actual): October 10, 2023
• Last Update Submitted That Met QC Criteria: October 7, 2023
• Last Verified: October 1, 2023

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pathologic Processes; Postoperative Complications; Pain; Neurologic Manifestations; Pain, Postoperative
• Other Study ID Numbers: Acute pain

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No