Risk Factors for Increased Postoperative Pain and Recommended Orderset for Postoperative Analgesic Usage
| Autor: | Sarah Black, Susan E. Hassenbein, April D. Armstrong, Christopher S. Hollenbeak |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Analgesic MEDLINE Alcohol abuse surgery 03 medical and health sciences 0302 clinical medicine Risk Factors 030202 anesthesiology medicine Humans pain perioperative Retrospective Studies Analgesics Pain Postoperative business.industry opioids Retrospective cohort study Multimodal therapy Original Articles medicine.disease Analgesics Opioid Anesthesiology and Pain Medicine Sexual abuse Orthopedic surgery Physical therapy Anxiety Neurology (clinical) medicine.symptom business 030217 neurology & neurosurgery |
| Zdroj: | The Clinical Journal of Pain |
| ISSN: | 0749-8047 |
| DOI: | 10.1097/ajp.0000000000000876 |
| Popis: | Objective An interdisciplinary pain team was established at our institution to explore options for improving pain control in patients undergoing orthopedic surgery by identifying traits that put a patient at increased risk for inadequate pain control postoperatively. Materials and methods The interdisciplinary pain team identified 7 potential risk factors that may lead to inadequate pain control postoperatively including (1) history of physical, emotional, or sexual abuse; (2) history of anxiety; (3) history of drug or alcohol abuse; (4) preoperative nonsteroidal anti-inflammatory drug, or disease-modifying antirheumatic drug use; (5) current opioid use; (6) psychological conditions other than anxiety; and (7) current smoker. Statistical analysis determined which risk factors were associated with increased preoperative and postoperative pain scores. Results A total of 1923 patients undergoing elective orthopedic surgery were retrospectively identified. Hip, knee, and shoulder replacements accounted for 76.0% of the procedures. 78.5% of patients had 3 or fewer risk factors and 17.1% had no risk factors. Anxiety, other psychological conditions, current opioid use, and current smoking were significantly associated with higher preoperative and postoperative pain scores. Discussion We found a significant association between anxiety, current smoking, psychological conditions, and current opioid use with increased preoperative and postoperative reported pain score. We propose that identification of these risk factors should prompt more attention to postoperative pain control plans and will improve communication with patients and providers. We recommend a multimodal approach to postoperative pain control, and developed a pain orderset to help guide providers. |
| Databáze: | OpenAIRE |
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