Effect of a comfort scale compared with a pain numerical rate scale on opioids consumption in postanaesthesia care unit: the COMFORT study.

Autor:	Fusco N; CHU Rennes, Anesthesia and Intensive Care Department, Rennes, France; Private Hospital, Anesthesia Department, Saint-Grégoire, France; Hypnosis Institute, Émergences Campus, F-35000 Rennes, France., Meuret L; CHU Rennes, Anesthesia and Intensive Care Department, CIC 1414, Rennes, France., Bernard F; Private Hospital, Anesthesia Department, Saint-Grégoire, France; Hypnosis Institute, Émergences Campus, F-35000 Rennes, France., Musellec H; Private Hospital, Anesthesia Department, Saint-Grégoire, France; Hypnosis Institute, Émergences Campus, F-35000 Rennes, France., Martin L; Private Hospital, Anesthesia Department, Saint-Grégoire, France; Hypnosis Institute, Émergences Campus, F-35000 Rennes, France., Léonard M; CHU Rennes, Inserm, CIC 1414, Rennes, France., Lasocki S; CHU d'Angers, University of Angers, Anesthesia and Intensive Care Department, Angers, France., Gazeau T; Clinique Jules Verne, Department of Anaesthesiology, Nantes, France., Aubertin R; Clinique Saint-Jean, Department of Anaesthesiology, Saint-Jean-de-Védas, France., Blayac D; Clinique du Parc, Department of Anaesthesiology, Lyon, France., Leviel F; CHU Amiens-Picardie, Anesthesiology and Critical Care Department, Amiens, France., Danguy des Deserts M; HIA Clermont-Tonnerre, Department of Anaesthesiology, University of Brest, Inserm, UMR1304-GETBO, Brest, France., Madi-Jebara S; Hôpital Hôtel Dieu de France, Anesthesia and Intensive Care Department, Beirut, Lebanon., Fessler J; Hôpital Foch, Department of Anesthesiology, Suresnes, France; Department of anesthesiology, University of Versailles-Saint-Quentin-en-Yvelines, Versailles, France., Lecoeur S; CH Saint-Brieuc, Department of Anesthesiology, Saint-Brieuc, France., Cirenei C; CHU Lille, Department of Anesthesiology, Critical Care and Pain Medecine, Lille, France., Menut R; CHU Toulouse Purpan, Hôpital Riquet, Anesthesia and Intensive Care Department, University Toulouse 3-Paul Sabatier, Toulouse, France., Lebreton C; Polyclinique Saint-Laurent, Department of Anesthesiology, Rennes, France., Bouvier S; Groupe Hospitalier Mutualiste, Department of Anesthesiology, Grenoble, France., Bonnet C; CHU Toulouse, Anesthesia and Intensive Care Department, Université Paul Sabatier, Toulouse, France., Maurice-Szamburski A; Clinique Juge, Almaviva, Department of Anesthesiology, Marseille, France., Cattenoz M; CH Fleyriat, Department of Anesthesiology, Bourg-en-Bresse, France., El Alami M; CH La Rochelle, Department of Anesthesiology, La Rochelle, France., Brocas E; CH Sud Francilien, Anesthesia and Perioperative Medicine Department, Corbeil-Essonnes, France., Aveline C; Hôpital Privé Sévigné, Department of Anesthesiology, Cesson-Sévigné, France., Gueguen L; CH Bretagne Atlantique, Department of Anesthesiology, Vannes, France., Noll E; CHU Strasbourg, Hôpital de Hautepierre, Anesthesia, Intensive Care and Perioperative Medicine Department, Strasbourg, France., Gouel-Chéron A; Hopital Beaujon, Departement of Anesthsiology, Paris Cité Université, Paris, France; Anaesthesiology and Critical Care Medicine Department, DMU PARABOL, Bichat Hospital, AP-HP, Paris, France; Institut Pasteur, Université Paris Cité, INSERM UMR1222, Antibodies in Therapy and Pathology, Paris, France., Evrard O; CHU Tours Hôpital Bretonneau, Department of Anesthesiology and Intensive Care, Tours, France., Fontaine M; Hôpital Saint Joseph Saint Luc, Anesthesia and Intensive Care Department, Lyon, France., Nguyen YL; Hôpital Cochin, APHP, Anesthesia and Intensive Care Department, Université Paris Cité, Paris, France., Ravry C; CH Dax-Côte d'Argent, Department of Anesthesiology, Dax, France., Boselli E; CH Pierre Oudot, Department of Anesthesiology, Bourgoin-Jallieu, France., Laviolle B; CHU Rennes, University of Rennes, Inserm, UMR_S 1085, CIC 1414, Rennes, France., Beloeil H; University of Rennes, CHU Rennes, Inserm, COSS1242, CIC 1414, Anesthesia and Intensive Care Department, Rennes, France. Electronic address: helene.beloeil@chu-rennes.fr.
Jazyk:	angličtina
Zdroj:	British journal of anaesthesia [Br J Anaesth] 2024 Oct; Vol. 133 (4), pp. 839-845. Date of Electronic Publication: 2024 Sep 07.
DOI:	10.1016/j.bja.2024.06.029
Abstrakt:	Background: The way that pain is assessed in the PACU could impact on postoperative pain and analgesic consumption. However, there is currently no evidence to support this speculation. The authors hypothesised that using a comfort scale reduces postoperative opioid consumption when compared with a standard numerical rating scale (NRS) to evaluate pain in the PACU. Methods: In this cluster-randomised trial, patients were assessed using either a comfort scale (comfort group) or a pain NRS (NRS group). The primary outcome was the opioid consumption in the PACU. The main secondary outcomes were postoperative pain, nausea and vomiting, length of stay in the PACU, and satisfaction. Results: Of 885 randomised patients, 860 were included in the analysis. Opioid consumption in the PACU was comparable in the comfort and NRS groups (median [interquartile range [IQR] 0 (0-5) vs 0 (0-6); P=0.2436), irrespective of the type of surgical procedure. The majority of patients did not need any postoperative opioid (59% in the comfort group and 56% in the NRS group, P=0.2260). There was no difference in postoperative pain, nausea and vomiting, time to reach an Aldrete score ≥9 after extubation, and global satisfaction. Conclusions: Using a comfort scale to assess pain in the PACU did not spare any opioid compared with use of a standard NRS. Further studies focusing on patients at risk of increased postoperative opioid consumption are necessary. Clinical Trial Registration: NCT05234216. (Copyright © 2024 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.)
Databáze:	MEDLINE
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