Pre-operative analgesia in the accident and emergency department

Abstract

Objective: To evaluate the adequacy of pre-operative analgesia and patient's satisfaction at the accident and emergency department, in terms of pain relief.

Study design: Observational study.

Place and duration of study: The Accident and Emergency Department (A&E) of Civil Hospital, Karachi, during April and May, 2007.

Methodology: Patients presenting with acute abdomen or tauma were included. Visual Analogue Scale (VAS) was used to grade severity of pain. Pain at presentation, analgesic prescribed, post-analgesic residual pain and patient satisfaction were assessed.

Results: A total of 166 patients (109 males and 57 females) were enrolled in the study. It included 98 (59%) cases of trauma and 68 (41%) patients with acute abdomen. Mean pain score was 6.95+/-2.03 on VAS. Female patients (p=0.008) and patients with acute abdomen (p<0.001) experienced significantly more pain as compared to male and trauma patients respectively. Analgesics were prescribed to 104 (62.7%) patients. Post-analgesic mean residual pain score was 5.0+/-1.8. Out of them, 47.1% patients waited to be given more analgesia. There was significant less prescription of analgesic to patients with acute abdomen (52.9%) as compared to trauma patients (26.5%) (p=0.001). Overall, more than half of the patients (59.6%) were not satisfied with the pre-operative analgesic treatment in the A&E department.

Conclusion: Pre-operative analgesia was underprescribed and pain was undertreated in accident and emergency department resulting in more than half patients being not satisfied.