Postoperative pain is undertreated: results from a local survey at Jordan university hospital

Postoperative pain management is nowadays considered an integral part of modern surgical practice. An audit was made in 2010 to assess the status of acute postoperative pain management at Jordan University Hospital. Data were collected from patients' files and through face-to-face interviews of all patients aged over 16 years who underwent general, gynaecological, ear-nose-throat and orthopaedic surgery. Of 275 patients, 72.0% experienced moderate to severe pain postoperatively at rest and 89.3% on movement. No analgesics were prescribed to 4.7% of the patients and of the remainder, a single analgesic was prescribed to 51.5%. Pethidine and paracetamol were the drugs most commonly prescribed [to 66.9% and 42.5% of patients respectively], most often on a regular schedule rather than on-demand. Despite improvements in pain management worldwide, patients at this hospital were still suffering from postoperative pain. Awareness among professionals and the public is needed and a structured acute pain management programme is essential

Doppler ultrasound-guided brachiocephalic central line insertion in cardiac surgery: an overlooked approach revisited

The insertion of central venous lines is sometimeschallenging for both the physician andthe patient. In a previous work from our institute,Badran et al. described brachiocephaliccentral line insertion as an overlookedapproach and recommended its use in clinicalpractice. The aim of this study is to evaluateultrasound-guided brachiocephalic centralline insertion in patients undergoing cardiacsurgery. Twenty-six low-risk patients undergoingcoronary bypass surgery consented toparticipate in the study (14 male, 12 female).Ultrasound-guided brachiocephalic centralline insertion was performed, and the mainoutcomes measured were the success rate andthe ease of cannulation. The procedure wassuccessful in 24 patients (92.3%), while itfailed in two (7.7%). The single-puncture successrate was 79.3% (19 out of 24), with noacute or late complications. Using Dopplerultrasound guidance, the brachiocephalic veinis a suitable site for central venous catheterinsertion in cardiac surgery (AU)

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