Postoperative Pain Management in Patients Undergoing Intestinal or Colorectal Surgery for Non-Oncological Diseases

Activity: Talk or presentation types › Oral presentation

Description

Postoperative analgesia is important for rapid recovery thus reducing hospitalization length. Procedure-specific analgestic guidelines for intestinal surgery recommend multimodal individualized therapy. The aim of the study is to investigate the existing postoperative analgesia practice in patients undergoing intestinal or colorectal surgery for non-oncological diseases and its compliance with good analgesia practice protocol in one medical center in different timepoints.. This retrospective cross-sectional study included adults (≥ 18 years); hospitalized in Pauls Stradins Clinical University hospital surgery departments in 2018, 2020 undergoing colorectal or intestinal surgery. Exclusion criteria: hospitalization postoperatively in the intensive care unit >3 days. Drug choice, dosing, route of administration and monitoring were evaluated.. Totally 64 patients match inclusion criteria (36 in 2018 and 28 in 2020). Frequently used analgesics are trimeperidine (85.9%), metamizole (50.0%) and ketorolac (32.8%). Use of multimodal analgesia increases in 2020 from 10 (27.8%) patients in 2018 to 19 (67.9%) along with use of documented unambiguous opioid administration criteria from 10 (32.3%)- 23 (95.8%). Non-recommended intramuscular route and lack of switch to peroral therapy when possible, observed in both years – 86.1% cases in 2018 and 89.3% cases in 2020. Decline in 2020 seen in agranulocytosis monitoring using metamizole for >3 consecutive days from 16 (84.2%) - 2 (22.2%) patients. Allergies and drug contraindications are addressed when prescribing an analgesic in 35 (97.2%) in 2018 and 28 (100%) patients in 2020. The maximum permissible doses not exceeded, 2 or more non-steroidal anti-inflammatory drugs not combined for all patients, however pain score was not properly documented in any patient using it only regarding opioid administration. . Multimodal analgesia is partially applied, often using solely trimeperidine. Underutilized are the uses of pain score and peroral drug administration favoring parenteral, even intramuscular route. Although therapy is safe regarding drug contraindications and prescribed doses, metamizole specific monitoring is deficient.
Period29 Mar 2023
Event titleRSU International Research Conference 2023: Knowledge for Use in Practice
Event typeConference
OrganiserRīga Stradiņš University
LocationRiga, LatviaShow on map
Degree of RecognitionInternational

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