Impact of preoperative education on pain management outcomes after coronary artery bypass graft surgery: a pilot

Abstract

Patients have been found to receive inadequate analgesia despite moderate to severe pain after coronary artery bypass graft (CABG) surgery. The purpose of this pilot study was to evaluate a preadmission educational booklet for patients undergoing their first uncomplicated CABG. A randomized controlled trial (RCT) was undertaken at the largest cardiovascular centre in Canada. Repeated measures were used to compare data from 3 interviews: at baseline, day 3, and day 5. Patients were randomly assigned to one of 3 groups at the preadmission clinic 2 to 7 days before surgery: (1) generic hospital booklet and videotape (control), (2) control + pain booklet, or (3) control + pain booklet and interview; 45 subjects completed all 3 interviews. Measures were the McGill Pain Questionnaire-Short Form and the American Pain Society Patient Outcome Questionnaire. For all groups, analgesic administration was inadequate (19.89[13.37] mg morphine equivalents/24 hours) despite unrelieved pain (6.63[2.46], 0-10). However, patients receiving the interventions in addition to control care received 46% more analgesia than patients receiving control care alone and had fewer concerns about asking for help and taking analgesia. Changes were not required in the intervention booklet or measures.