Evaluating patient outcomes in postoperative pain management according to the revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R).

BACKGROUND: In the first 24 h after surgery, it is necessary to evaluate the patient responses to pain, analgesia and patient satisfaction to prevent complications related to the pain management process. AIM: To evaluate patients' outcomes (pain qualities, side effects of the pain management, pain treatment satisfaction, non-pharmacological pain treatment methods, predictors of pain management satisfaction and percentage of pain relief) according to the Revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R) in the first 24 h. DESIGN: Cross-sectional study. METHODS: The study sample was comprised of 700 patients, who were surgically treated at the surgical clinics of a university hospital and completed the first postoperative 24 h. The data was collected through the "Patient Information Form" and the "Turkish version of the revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R)". RESULTS: The medians of the lowest and the worst postoperative pain severity level were 3.0 and 7.0, respectively. Patients experienced severe pain in 60 % of the first postoperative 24 h and reported that 70 % of their pain eventually decreased. A positive and significant correlation was found between pain interference, pain-affected mood/emotions, the severity of pain-related side effects, the least and worst pain severity levels and severe pain, and the percentage of time experienced with severe pain. CONCLUSIONS: Most of the patients experienced severe pain, which restricted their daily life activities and led to negative emotions. Acute postoperative pain may negatively affect patient outcomes and delay postoperative recovery during the early period. Therefore, pain should be managed in the early period to prevent physical and psychological side effects.

The Effect of Preoperative Fear of Pain on Postoperative Pain Levels and the Amount of Analgesic Consumption.

BACKGROUND: Preoperative fear of pain can increase the surgical stress response along with anxiety, increasing postoperative pain and the amount of analgesia consumption. AIMS: To determine the effect of preoperative fear of pain on postoperative pain level and analgesic consumption. DESIGN: A descriptive, cross-sectional design was used. METHODS: A total of 532 patients who were scheduled for a variety of surgical procedures in a tertiary hospital were included in the study. Data were collected using Patient Identification Information Form and Fear of Pain Questionnaire-III. RESULTS: 86.1% of the patients thought that they would experience postoperative pain, and 70% of the patients reported moderate-to-severe postoperative pain. The examination of the postoperative first 24-hour pain levels indicated that there was a significant positive correlation between patients' pain levels within 0-2 hours and their mean scores on the fear of severe and minor pain sub-dimensions and the total scale and between pain experienced within 3-8 hours and their scores on the fear of severe pain sub-dimension (p <.05). Also, a significant positive correlation was found between patients' mean scores on the total fear of pain scale and the amount of nonopioid (diclofenac sodium) consumption (p <0.05). CONCLUSIONS: The fear of pain increased patients' postoperative pain levels, and thus the amount of analgesic consumption. Therefore, patients' fear of pain should be determined in the preoperative period, and pain management practices should be initiated in this period. As a matter of fact, effective pain management will positively affect patient outcomes by reducing the amount of analgesic consumption.

Assessment of the risk factors for intraoperative pressure injuries in patients.

AIM: This study was conducted to assess the risk factors for pressure injuries in patients during surgery. METHODS: In this descriptive cross-sectional study, the risk of pressure injuries during surgery was evaluated in 250 patients in a university hospital. Data were collected through a Patient Descriptive Information Form (PDIF) and the 3S Intraoperative Pressure Injury Risk Assessment Scale (IPIRAS). RESULTS: The mean age of the patients was 44.15 ± 17.00, and 52.4% were female. In addition, it was determined that the mean 3S IPIRAS score was higher in patients who were male, were aged ≥60 years, were obese, had a chronic disease, and had low serum albumin and hemoglobin levels (p < .05). During the surgery of the patients included in the study, support surfaces were used in 67.6%, positioning aids were used in 82.4%, and 55.6% had normal skin. Patients who underwent CVS procedures for more than 6 h, did not use support surfaces during surgery, had moist skin, or used vasopressors had higher and significantly different mean 3S IPIRAS scores (p < .05). CONCLUSIONS: According to the results, all surgical patients were at risk for pressure injury in the intraoperative period. In addition, it was found that male gender was associated with risk factors and that being aged ≥60 years, obesity, chronic disease, low serum hemoglobin and albumin levels, CVS, operations lasting more than 6 h, moist skin, vasopressor drugs, and not using support surfaces during surgery increased the risk of pressure injuries significantly.

Assessment of Procedural Pain in Patients with COVID-19 in the Intensive Care Unit.

AIM: The purpose of the study was to assess the level of procedural pain in patients treated in the COVID-19 intensive care unit, in a tertiary university hospital. METHOD: We performed the procedural pain assessment of COVID-19 patients in this study, and 162 (93.6 %) of 173 hospitalized patients assessed during this period. While pain was assessed before, during, and at the 20th minute after endotracheal aspiration, wound care, and position change, which are procedural patient practices, the pain was assessed before, during, and up to the fourth hour after prone positioning, high-flow oxygen therapy (HFOT), and the non-invasive mechanical ventilation (NIMV) procedure. The Numerical Pain Scale was used for conscious patients in pain assessment, while the Behavioral Pain Scale and the Richmond Agitation-Sedation Scale were used for unconscious patients. RESULTS: Patients who underwent endotracheal aspiration, wound care, and positioning had higher pain levels during procedure than other time points. Patients in the prone position with HFOT and NIMV applied had the highest pain scores at fourth hour after procedure; this increase was statistically significant (p = .000, p < .05). CONCLUSIONS: The study found that COVID-19 patients in the ICU had pain due to procedural practices and that the level of pain during the procedures was higher because endotracheal aspiration, wound care, and positioning were all short-term procedures. Moreover, prone positioning was found to be associated with pressure-related tissue damage, and patients' pain levels increased with the increasing duration of HFOT and NIMV procedure.