Implementation of the pre-operative rehabilitation recovery protocol and its effect on the quality of recovery after colorectal surgeries / 中华医学杂志(英文版)

BACKGROUND@#Patients' recovery after surgery is the major concern for all perioperative clinicians. This study aims to minimize the side effects of peri-operative surgical stress and accelerate patients' recovery of gastrointestinal (GI) function and quality of life after colorectal surgeries, an enhanced recovery protocol based on pre-operative rehabilitation was implemented and its effect was explored.@*METHODS@#A prospective randomized controlled clinical trial was conducted, patients were recruited from January 2018 to September 2019 in this study. Patients scheduled for elective colorectal surgeries were randomly allocated to receive either standardized enhanced recovery after surgery (S-ERAS) group or enhanced recovery after surgery based on pre-operative rehabilitation (group PR-ERAS). In the group PR-ERAS, on top of recommended peri-operative strategies for enhanced recovery, formatted rehabilitation exercises pre-operatively were carried out. The primary outcome was the quality of GI recovery measured with I-FEED scoring. Secondary outcomes were quality of life scores and strength of handgrip; the incidence of adverse events till 30 days post-operatively was also analyzed.@*RESULTS@#A total of 240 patients were scrutinized and 213 eligible patients were enrolled, who were randomly allocated to the group S-ERAS (n = 104) and group PR-ERAS (n = 109). The percentage of normal recovery graded by I-FEED scoring was higher in group PR-ERAS (79.0% vs. 64.3%, P  0.050).@*CONCLUSIONS@#Peri-operative rehabilitation exercise might be another benevolent factor for early recovery of GI function and life of quality after colorectal surgery. Newer, more surgery-specific rehabilitation recovery protocol merits further exploration for these patients.@*TRIAL REGISTRATION@#ChiCTR.org.cn, ChiCTR-ONRC-14005096.

A Multi-centered Cross-sectional Study of Disease Burden of Pain of Inpatients in Southwest China / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Pain is a common burden of disease globally; yet, it is not systematically investigated in China, especially in hospitalized patients. This study was aimed at clarifying the epidemiological characteristics of pain and related factors in hospitalized patients in Southwest China.</p><p><b>METHODS</b>A cross-sectional study was conducted to investigate the prevalence, severity, and influencing factors of pain and modes of postoperative analgesia in hospitalized patients from 17 hospitals in Southwest China. A prevalidated questionnaire was employed to calibrate all of these items within 3 days from March 18, 2015 to March 20, 2015.</p><p><b>RESULTS</b>A total of 2293 patients were surveyed, the incidence of pain was 57.4% in all hospitalized patients at rest, of which 62.1% were with acute pain and 37.9% had persistent to chronic pain. Among surgical patients, 90.8% of them complained of acute postoperative pain at rest and 97.1% in motion. The incidence of acute postoperative moderate-to-severe pain was 28.8% at rest and 45.1% in motion. Surgical patients reported higher incidences of pain, especially acute and persistent pain compared with nonsurgical patients (P < 0.05). Postoperative pain occurred predominately at surgical sites (95.2%) as compared with nonsurgical sites (4.8%). Agedness, lower education level, surgery, and history of smoking were factors associated with increased duration and severity of postoperative pain and nonsurgical pain (P < 0.05).</p><p><b>CONCLUSIONS</b>Pain is a common burden of disease in China, of which surgical pain constituted an important component. Surgical patients complained more severe pain than those who did not undergo surgery. Postoperative analgesia still needs to be improved to control pain after surgery. Patients' perception might influence the efficacy of pain management, which should be implemented with a multidisciplinary approach.</p>

A cross-sectional study of pain burden of 2 106 adult patients during hospitalization and its clinical implication / 第二军医大学学报

Objective To investigate the pain burden and pain-related health seeking behaviors in adult patients during hospitalization in the First Affiliated Hospital of Chongqing Medical University, so as to improve the diagnosis and treatment of pain and improve patient satisfaction.Methods A short-term cross-sectional questionnaire survey (72 h) was carried out to investigate the adult patients during hospitalization from July 22nd to July 24th, 2013 in our hospital. Results The effective questionnaire response rate was 84%(2 106/2 515). The incidence of pain was 46.96% (989/2 106) in this research. It was found that 68.24%(651/954) of surgical patients having a pain duration less than 1 month. The incidences of moderate-severe pain of surgical patients was 34.80%(332/954) at rest pre-operatively and 28.83%(275/954) post-operatively. We found that 79.91% (1 683/2 106) of patients thought the pain was caused by disease, and 81.10% (764/942) of the patients thought the treatment for pain by the doctors was effective. Age and education level were found to be the factors influencing the pain burden of patients(P<.05). Conclusion Pain burden is common among adult patients during hospitalization. The incidence of surgical pain is high, with acute and mild pain being the most. The patients have a high degree of awareness of pain and a high satisfactory rate with pain control; however, some pain is still not well controlled. Medical staffs should receive systematic and scientific training and give individual analgesic measures, so as to reduce the prevalence of pain and further improve patient satisfaction.