Pre-operative analgesia in the accident and emergency department

ABSTRACT

To evaluate the adequacy of pre-operative analgesia and patient's satisfaction at the accident and emergency department, in terms of pain relief. Observational study. The Accident and Emergency Department [A and E] of Civil Hospital, Karachi, during April and May, 2007. 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. 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 and E department. Pre-operative analgesia was underprescribed and pain was undertreated in accident and emergency department resulting in more than half patients being not satisfied