Author(s): Rina O. Kotake, M.D. and Stephen Sixto Siguan, M.D., F.P.C.S.
To describe common practices in pain assessment and control of surgery patients at Cebu Velez General Hospital (CVGH).
Records of adult patients admitted to the Department of Surgery within January to June 2014 were reviewed. Data collected were method of pain monitoring, pain scores and analgesics given on admission, operation done, pain within and beyond 24 hours postoperatively, analgesics given 24 hours post-operatively, and upon discharge.
Results: A total of 176 operations were included in this survey. Fifty one percent of the operations were under general surgery. Pain monitoring was done by the surgical clerks. Not one chart had pain monitoring documented in the vital signs monitoring sheets. Thirty two percent had no pain assessment on admission. Among those with pain assessment on admission, 60.5% suffered from significant pain. Tramadol was the most frequent parenteral analgesics given at 80% on admission as well as postoperatively and upon discharge. Tramadol+paracetamol combination was the most prescribed oral analgesics post-operatively. Within 24 hours after surgery, 40.9% of patients had no recorded pain assessments. Half of those patients assessed suffered from significant pain while still in the hospital. Beyond 24 hours post-op, 47.7% had no documented pain assessment. Almost a third of the patients assessed for pain had significant pain.
Postoperative pain assessment and control have been poorly addressed among surgical patients from admission to discharge. Tramadol was the most commonly utilized analgesic whether parenteral, oral, monotherapy or in combination with a nonopioid analgesic.
Key words: Postoperative pain, pain assessment, tramadol