1
|
Wang P, Zhang Q, Li GP, Xu N, Wang Z, Zhao YH, Zou YY, Liu YF, Wang LM. Effectiveness of a Teach-Back Education Program on Perioperative Pain in Patients With Lung Cancer: An Intervention Study Using Behavior Change Wheel. Pain Manag Nurs 2024; 25:402-408. [PMID: 38609805 DOI: 10.1016/j.pmn.2024.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 03/10/2024] [Accepted: 03/12/2024] [Indexed: 04/14/2024]
Abstract
OBJECTIVE To assess the effect of a teach-back educational intervention using Behavior Change Wheel (BCW) framework on perioperative pain among patients with lung cancer. METHODS A prospective quasi-experimental study was conducted in 88 patients with lung cancer from a tertiary hospital in China. According to the order of admission, they were allocated to either control group or intervention group, with 44 patients in each group. Patients in the control group received routine nursing care, while patients in the intervention group were given a teach-back education program based on BCW framework. The visual analog scale (VAS) was adopted to evaluate patients' pain on the day of surgery (T0), 1 (T1), 2 (T2), and 3 (T3) days after surgery. We also recorded the use of patient-controlled analgesia (PCA), the length of hospital stay, and the degree of patients' satisfaction. RESULTS Rest pain, pain when coughing, and pain during activity that patients in the intervention group experienced were significantly less severe than those in the control group on T0 and T1. The pain when coughing in the intervention group was also significantly milder on T2 and T3. In addition, the number of self-control time, use duration, and total dose of PCA were significantly lower in the intervention group. Moreover, patients' satisfaction of nursing service was significantly higher in the intervention group. CONCLUSION A teach-back education program based on BCW framework was effective in pain management among the perioperative patients with lung cancer. This study demonstrates the application of teach-back method and the BCW in the development of patient education intervention to mitigate perioperative pain.
Collapse
Affiliation(s)
- Peng Wang
- Department of International Medical Care, Peking Union Medical College Hospital, Beijing, China
| | - Qian Zhang
- Department of International Medical Care, Peking Union Medical College Hospital, Beijing, China
| | - Gui-Ping Li
- Department of General Surgery, Peking Union Medical College Hospital, Beijing, China
| | - Ning Xu
- Department of General Surgery, Peking Union Medical College Hospital, Beijing, China
| | - Zhuo Wang
- Department of General Surgery, Peking Union Medical College Hospital, Beijing, China
| | - Yan-Hong Zhao
- Department of International Medical Care, Peking Union Medical College Hospital, Beijing, China
| | - Yi-Yan Zou
- Department of International Medical Care, Peking Union Medical College Hospital, Beijing, China
| | - Yuan-Fei Liu
- Department of Nursing, The Second Affiliated Hospital Zhejiang University School of Medicine, Zhejiang University, Hangzhou, China
| | - Li-Mei Wang
- Department of International Medical Care, Peking Union Medical College Hospital, Beijing, China.
| |
Collapse
|
2
|
Lovasi O, Gaál P, Frank K, Lám J. Acute Pain Services and pain-related patient-reported outcomes in Hungarian hospitals. Perioper Med (Lond) 2024; 13:18. [PMID: 38475942 DOI: 10.1186/s13741-024-00373-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 03/01/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Postoperative pain management is an important part of surgical care, where Acute Pain Service offers added value in terms of patient outcomes and costs. The technology, however, has hardly been adopted in Hungary, with only two hospitals operating Acute Pain Service and whose performance has not been evaluated yet. This research compared pain management outcomes of surgical, orthopedic, and traumatology patients in Hungarian hospitals with and without Acute Pain Service. METHODS We recruited 348 patients, 120 in the APS group and 228 in the control group, whose experience was surveyed with an adapted version of the American Pain Society Patient Outcome Questionnaire. The questionnaire covered pain intensity, pain interference with physical and emotional functions, side effects, patient satisfaction, information received, and participation in treatment decisions. The differences were analyzed by Fisher's exact test and Mann-Whitney U test. RESULTS The APS group showed better results with lower pain intensity scores regarding worst postoperative pain (χ2 = 18.919, p = 0.0043). They reported less pain interference with activities in bed (χ2 = 21.978, p = 0.0006) and out of bed (χ2 = 14.341, p = 0.0129). Furthermore, patients in the APS group experienced fewer pain-management-related side effects, like nausea (χ2 = 15.240, p = 0.0101), drowsiness (χ2 = 26.965, p = 0.0001), and dizziness (χ2 = 13.980, p = 0.0124). However, patient information (χ2 = 3.480, p = 0.0945) and patient satisfaction (χ2 = 5.781, p = 0.2127) did not differ significantly between the two groups. CONCLUSIONS Our findings confirm earlier international evidence on the benefits of Acute Pain Service in postoperative pain management and support the wider adoption of the technology in Hungarian hospitals. Nevertheless, close attention should be paid to patient information and involvement as better outcomes alone do not necessarily increase patient satisfaction.
Collapse
Affiliation(s)
- Orsolya Lovasi
- School of PhD Studies, Semmelweis University, Üllői Út 26, 1085, Budapest, Hungary.
| | - Péter Gaál
- Health Services Management Training Center, Semmelweis University, Budapest, Hungary
- Department of Applied Social Sciences, Sapientia Hungarian University of Transylvania, Targu Mures, Romania
| | - Krisztián Frank
- Szekszárd District Office of the Government Office of Tolna County, Szekszárd, Hungary
| | - Judit Lám
- Health Services Management Training Center, Semmelweis University, Budapest, Hungary
- NEVES Society for Patient Safety, Budapest, Hungary
| |
Collapse
|
3
|
Andrade Filho PHD, Pereira VE, Sousa DDEM, Costa LDG, Nunes YP, Taglialegna G, de Paula-Garcia WN, Silva JM. Analgesic efficacy of erector spinae plane block versus paravertebral block in lung surgeries-A non-inferiority randomised controlled trial. Acta Anaesthesiol Scand 2024; 68:71-79. [PMID: 37646584 DOI: 10.1111/aas.14325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 06/19/2023] [Accepted: 08/16/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND Pain management plays an essential role in postoperative recovery after lung surgeries. The Erector Spinae Plane Block (ESPB) is a widely used regional anaesthesia technique; however, few clinical trials have compared this block to active control in thoracic surgeries. This study evaluated the non-inferiority of the analgesia provided by ESPB when compared to paravertebral block (PVB) in lung surgeries. METHODS Randomised, active-controlled, blinded for patients and assessors, non-inferiority trial. Patients who underwent unilateral lung surgeries were divided into two groups according to the regional anaesthesia technique-continuous ESPB or PVB at the T5 level. The primary outcome was to assess pain using a numerical rating scale (NRS) with a test of the interaction of three measures over 24 h postoperatively. An NRS score ≥ 7 was considered analgesia failure, and the prespecified non-inferiority margin was 10%. RESULTS In the interim analysis that terminated this study, 120 participants were enrolled. ESPB patients reported higher mean NRS general values over 24 h, 4.6 ± 3.2 in the ESPB group versus 3.9 ± 2.9 in the PVB group, with a difference of -0.67 (-15.2%) and 95%CI: -1.29 to -0.05 (p = .02), demonstrating not non-inferiority. In addition, the ESPB group presented higher NRS failure of analgesia over 24 h (p < .01) and required more postoperative opioids (p = .01 over 24 h). There was no difference in patient satisfaction between groups. CONCLUSION This trial demonstrated that a continuous erector spinae plane block was not non-inferior to a continuous paravertebral block for analgesia after lung surgery but resulted in higher levels of postoperative pain and opioid consumption.
Collapse
Affiliation(s)
- Pedro Hilton de Andrade Filho
- Department of Anaesthesiology, Hospital do Servidor Publico Estadual de São Paulo, São Paulo, Brazil
- Postgraduate Programme in Anaesthesiology, Surgical Sciences, and Perioperative Medicine, University of São Paulo Faculty of Medicine (FMUSP), São Paulo, Brazil
| | - Victor Egypto Pereira
- Orthopedics and Anaesthesiology Department, Ribeirão Preto Medical School, University of Sao Paulo (FMRP-USP), Ribeirão Preto, Brazil
| | | | - Ladyer da Gama Costa
- Department of Anaesthesiology, Hospital do Servidor Publico Estadual de São Paulo, São Paulo, Brazil
| | - Yuri Pinto Nunes
- Department of Anaesthesiology, Hospital do Servidor Publico Estadual de São Paulo, São Paulo, Brazil
| | - Giovani Taglialegna
- Orthopedics and Anaesthesiology Department, Ribeirão Preto Medical School, University of Sao Paulo (FMRP-USP), Ribeirão Preto, Brazil
| | - Waynice Neiva de Paula-Garcia
- Orthopedics and Anaesthesiology Department, Ribeirão Preto Medical School, University of Sao Paulo (FMRP-USP), Ribeirão Preto, Brazil
| | - Joao Manoel Silva
- Department of Anaesthesiology, Hospital do Servidor Publico Estadual de São Paulo, São Paulo, Brazil
- Postgraduate Programme in Anaesthesiology, Surgical Sciences, and Perioperative Medicine, University of São Paulo Faculty of Medicine (FMUSP), São Paulo, Brazil
| |
Collapse
|
4
|
Chenesseau J, Fourdrain A, Pastene B, Charvet A, Rivory A, Baumstarck K, Bouabdallah I, Trousse D, Boulate D, Brioude G, Gust L, Vasse M, Braggio C, Mora P, Labarriere A, Zieleskiewicz L, Leone M, Thomas PA, D’Journo XB. Effectiveness of Surgeon-Performed Paravertebral Block Analgesia for Minimally Invasive Thoracic Surgery: A Randomized Clinical Trial. JAMA Surg 2023; 158:1255-1263. [PMID: 37878299 PMCID: PMC10600725 DOI: 10.1001/jamasurg.2023.5228] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 07/01/2023] [Indexed: 10/26/2023]
Abstract
Importance In minimally invasive thoracic surgery, paravertebral block (PVB) using ultrasound (US)-guided technique is an efficient postoperative analgesia. However, it is an operator-dependent process depending on experience and local resources. Because pain-control failure is highly detrimental, surgeons may consider other locoregional analgesic options. Objective To demonstrate the noninferiority of PVB performed by surgeons under video-assisted thoracoscopic surgery (VATS), hereafter referred to as PVB-VATS, as the experimental group compared with PVB performed by anesthesiologists using US-guided technique (PVB-US) as the control group. Design, Setting, and Participants In this single-center, noninferiority, patient-blinded, randomized clinical trial conducted from September 8, 2020, to December 8, 2021, patients older than 18 years who were undergoing a scheduled minimally invasive thoracic surgery with lung resection including video-assisted or robotic approaches were included. Exclusion criteria included scheduled open surgery, any antalgic World Health Organization level greater than 2 before surgery, or a medical history of homolateral thoracic surgery. Patients were randomly assigned (1:1) to an intervention group after general anesthesia. They received single-injection PVB before the first incision was made in the control group (PVB-US) or after 1 incision was made under thoracoscopic vision in the experimental group (PVB-VATS). Interventions PVB-VATS or PVB-US. Main Outcomes and Measures The primary end point was mean 48-hour post-PVB opioid consumption considering a noninferiority range of less than 7.5 mg of opioid consumption between groups. Secondary outcomes included time of anesthesia, surgery, and operating room occupancy; 48-hour pain visual analog scale score at rest and while coughing; and 30-day postoperative complications. Results A total of 196 patients were randomly assigned to intervention groups: 98 in the PVB-VATS group (mean [SD] age, 64.6 [9.5] years; 53 female [54.1%]) and 98 in the PVB-US group (mean [SD] age, 65.8 [11.5] years; 62 male [63.3%]). The mean (SD) of 48-hour opioid consumption in the PVB-VATS group (33.9 [19.8] mg; 95% CI, 30.0-37.9 mg) was noninferior to that measured in the PVB-US group (28.5 [18.2] mg; 95% CI, 24.8-32.2 mg; difference: -5.4 mg; 95% CI, -∞ to -0.93; noninferiority Welsh test, P ≤ .001). Pain score at rest and while coughing after surgery, overall time, and postoperative complications did not differ between groups. Conclusions and Relevance PVB placed by a surgeon during thoracoscopy was noninferior to PVB placed by an anesthesiologist using ultrasonography before incision in terms of opioid consumption during the first 48 hours. Trial Registration ClinicalTrials.gov Identifier: NCT04579276.
Collapse
Affiliation(s)
- Josephine Chenesseau
- Department of Thoracic Surgery, Diseases of the Esophagus and Lung Transplantation, North Hospital, Aix Marseille University, Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - Alex Fourdrain
- Department of Thoracic Surgery, Diseases of the Esophagus and Lung Transplantation, North Hospital, Aix Marseille University, Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - Bruno Pastene
- Department of Anesthesiology and Intensive Care Medicine, North Hospital, Aix Marseille University, Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - Aude Charvet
- Department of Anesthesiology and Intensive Care Medicine, North Hospital, Aix Marseille University, Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - Adrien Rivory
- Department of Anesthesiology and Intensive Care Medicine, North Hospital, Aix Marseille University, Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - Karine Baumstarck
- Departement of Biostatistics, Aix Marseille University, Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - Ilies Bouabdallah
- Department of Thoracic Surgery, Diseases of the Esophagus and Lung Transplantation, North Hospital, Aix Marseille University, Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - Delphine Trousse
- Department of Thoracic Surgery, Diseases of the Esophagus and Lung Transplantation, North Hospital, Aix Marseille University, Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - David Boulate
- Department of Thoracic Surgery, Diseases of the Esophagus and Lung Transplantation, North Hospital, Aix Marseille University, Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - Geoffrey Brioude
- Department of Thoracic Surgery, Diseases of the Esophagus and Lung Transplantation, North Hospital, Aix Marseille University, Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - Lucile Gust
- Department of Thoracic Surgery, Diseases of the Esophagus and Lung Transplantation, North Hospital, Aix Marseille University, Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - Matthieu Vasse
- Department of Thoracic Surgery, Diseases of the Esophagus and Lung Transplantation, North Hospital, Aix Marseille University, Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - Cesare Braggio
- Department of Thoracic Surgery, Diseases of the Esophagus and Lung Transplantation, North Hospital, Aix Marseille University, Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - Pierre Mora
- Department of Anesthesiology and Intensive Care Medicine, North Hospital, Aix Marseille University, Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - Ambroise Labarriere
- Department of Anesthesiology and Intensive Care Medicine, North Hospital, Aix Marseille University, Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - Laurent Zieleskiewicz
- Department of Anesthesiology and Intensive Care Medicine, North Hospital, Aix Marseille University, Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - Marc Leone
- Department of Anesthesiology and Intensive Care Medicine, North Hospital, Aix Marseille University, Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - Pascal Alexandre Thomas
- Department of Thoracic Surgery, Diseases of the Esophagus and Lung Transplantation, North Hospital, Aix Marseille University, Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - Xavier-Benoit D’Journo
- Department of Thoracic Surgery, Diseases of the Esophagus and Lung Transplantation, North Hospital, Aix Marseille University, Assistance Publique-Hôpitaux de Marseille, Marseille, France
| |
Collapse
|
5
|
Bailey CR. Patients have great expectations, but there is more to do. Anaesthesia 2023; 78:1199-1202. [PMID: 37499115 DOI: 10.1111/anae.16105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2023] [Indexed: 07/29/2023]
Affiliation(s)
- C R Bailey
- Department of Anaesthesia and Peri-operative Medicine, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| |
Collapse
|
6
|
Shields J, Lin E, Kho K. Beyond the Scalpel: Broadening Our Focus to Optimize Surgical Experiences. J Minim Invasive Gynecol 2023; 30:425-426. [PMID: 37062459 DOI: 10.1016/j.jmig.2023.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 04/09/2023] [Indexed: 04/18/2023]
Affiliation(s)
- Jessica Shields
- Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX (all authors).
| | - Emily Lin
- Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX (all authors)
| | - Kimberly Kho
- Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX (all authors)
| |
Collapse
|
7
|
Schnabel K, Drusenbaum AM, Kranke P, Meybohm P, Wöckel A, Schnabel A. Determinants of satisfaction with acute pain therapy during and after childbirth. DIE ANAESTHESIOLOGIE 2023; 72:325-331. [PMID: 36799969 DOI: 10.1007/s00101-023-01260-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 12/29/2022] [Accepted: 01/18/2023] [Indexed: 02/18/2023]
Abstract
BACKGROUND An important task in obstetrics is to offer patients adequate pain management after vaginal delivery (VD) and after cesarean section (CS). The aim of the present analysis was to assess pain intensity at the day after childbirth, after 3 and 6 months in women after VD and after CS. Additionally, it was planned to identify determinants of maternal satisfaction with acute pain therapy following VD and CS. METHODS This secondary analysis of a single-center prospective cohort study included 210 parturients. The women gave birth in the University Hospital of Wuerzburg. They completed a survey before childbirth (P), on the first day (D1), 3 and 6 months after VD and CS. The survey included questions about the expected pain, the experienced pain, the birth, the pain afterwards and also psychological questionnaires. In addition, information was collected from the patient records. Women with planned CS received spinal anesthesia. A secondary CS was performed with an epidural, spinal or general anesthesia. Pain therapy on the ward was standardized. The primary outcomes were acute and chronic pain intensity at rest, during movement, determinants of satisfaction with pain therapy and the wish to have received more pain medication during and after VD and CS (D1). RESULTS A total of 175 women completed the survey at all time points and were available for the analysis (drop-out 16.8%). The results confirmed high pain levels at D1 after CS (median pain intensity during movement: 8 NRS points, interquartile range, IQR 6-9 points). After VD pain scores were much lower (median pain intensity during movement: 4 points, IQR 2-5 points). Of the mothers 7.4% reported pain at rest at all time points after VD or CS but pain intensity was low after 3 and 6 months (median pain intensity at rest: 2 points, IQR 0-3 points), 28% received extended-release opioids after CS and 33% of women (VD and CS) had an epidural. The most important influencing factor for lower satisfaction with pain therapy after CS or VD was inadequate pain relief. Women with VD who had an epidural, were more satisfied during delivery than women without but there was no difference at D1. DISCUSSION This study confirmed high acute pain levels following CS and an incidence of chronic pain of around 7% but pain intensity was low and one third received strong opioids after CS. Around 11% of women after primary CS (8% epidural, 3% combined spinal/epidural) and around 55% of women after secondary CS had an epidural, which could be used for pain therapy after birth. Women without an epidural or without opioids may not have had good pain management. The received pain relief appeared to be the most relevant predictor for satisfaction and the wish to have received more pain medication. Mothers having a VD with an epidural catheter were more satisfied with pain therapy during birth than those without. Therefore, a better multimodal pain management (including opioids, epidural and nonopioids) might provide better pain relief and might improve overall satisfaction with pain treatment following CS. Finally, the received pain relief might be a better patient-related outcome measure for satisfaction with pain treatment after childbirth than pain intensity alone.
Collapse
Affiliation(s)
- Kathrin Schnabel
- Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, Julius-Maximilians-University Wuerzburg, Wuerzburg, Germany
- Department of Anaesthesiology, Intensive Care and Pain Medicine, University Hospital of Muenster, Albert-Schweitzer Campus 1A, 48149, Muenster, Germany
| | - Ann-Marie Drusenbaum
- Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Peter Kranke
- Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Patrick Meybohm
- Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Achim Wöckel
- Department of Obstetrics and Gynecology, University Hospital of Wuerzburg, Wuerzburg, Germany
| | - Alexander Schnabel
- Department of Anaesthesiology, Intensive Care and Pain Medicine, University Hospital of Muenster, Albert-Schweitzer Campus 1A, 48149, Muenster, Germany.
- Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University Hospital Wuerzburg, Wuerzburg, Germany.
| |
Collapse
|
8
|
Al Sadah ZM, Alfaraj NH, AlAlwan NE, Al Dhaif LH, Khidr AM, Fallatah SM. Assessment of patients' satisfaction with the postanesthesia care unit service at University Hospital in Al Khobar, KSA. J Taibah Univ Med Sci 2022; 18:217-224. [PMID: 36817216 PMCID: PMC9926208 DOI: 10.1016/j.jtumed.2022.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 07/06/2022] [Accepted: 09/16/2022] [Indexed: 11/06/2022] Open
Abstract
Objectives The quality of health care is individually and subjectively reflected through patients' level of satisfaction, as well as the optimality and effectiveness of the provided postoperative pain management. The provision of postanesthesia care unit (PACU) service in hospitals has led to overall positive outcomes, in addition to the enhancement of patients' satisfaction with the provided pain management service. This study assessed patients' level of satisfaction with PACU service at a university hospital and discussed different factors that might have contributed to the level of satisfaction. Methods A prospective cross-sectional study was carried out among patients after being discharged from PACU. The study took place at King Fahad Hospital of the University in Al Khobar, KSA between November 2021 and February 2022. The data were collected using a three-section predesigned questionnaire. Results Two hundred patients were included in this study. Nearly all patients (95.5%) were satisfied with the provided pain management service. Almost all patients (99.5%) indicated that the PACU staff was courteous and professional during the entire pain management service. More patients complained about pain before using analgesia and this difference was statistically significant (Z = 8.642; p < 0.001). The satisfaction rate was significantly higher in the older age group (>45 years) (Z = 2.114; p = 0.035), in patients with American Society of Anesthesiology (ASA) 3 physical status (H = 13.130; p = 0.001), and those with a previous surgical history (Z = 2.139; p = 0.032). Conclusion This study concluded that the level of patients' satisfaction with PACU service was high, and established a statistically significant association with age, ASA score, and previous surgical history. Healthcare providers should consider patient education and effective communication to increase patients' satisfaction level and improve the overall quality of care.
Collapse
Key Words
- ASA, American Society of Anesthesiology
- Analgesia
- Anesthesia
- BMI, Body Mass Index
- GA, General anesthesia
- ICU, Intensive care unit
- IRB, Institutional Review Board (IRB)
- IV, Intravenous
- KFHU, King Fahad Hospital of the University
- OR, Operating room
- PACU, Postanesthesia care unit
- Patient satisfaction
- Postanesthesia care unit
- Preoperative education
- SCRELC, Standing Committee for Research Ethics on Living Creatures
- SPSS, Statistical Packages for Software Sciences
Collapse
Affiliation(s)
- Zhra M. Al Sadah
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, KSA,Corresponding address: Zhra Muneer Al Sadah, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, KSA.
| | - Noor H. Alfaraj
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, KSA
| | - Noor E. AlAlwan
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, KSA
| | - Lamees H. Al Dhaif
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, KSA
| | - Alaa M. Khidr
- Department of Anesthesia, King Fahad Hospital of the University, Al Khobar, KSA
| | | |
Collapse
|
9
|
Jiang B, Wu Y, Wang X, Gan Y, Wei P, Mi W, Feng Y. The influence of involving patients in postoperative pain treatment decisions on pain-related patient-reported outcomes: A STROBE-compliant registering observational study. Medicine (Baltimore) 2022; 101:e30727. [PMID: 36197159 PMCID: PMC9509085 DOI: 10.1097/md.0000000000030727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The evidence regarding the influence of allowing patients to participate in postoperative pain treatment decisions on acute pain management is contradictory. This study aimed to identify the role of patient participation in influencing pain-related patient-reported outcomes (PROs). This is a cross-sectional study. The data were provided by PAIN OUT (www.pain-out.eu). A dataset specific to adult Chinese patients undergoing orthopedic surgery was selected. The PROs were assessed on postoperative day 1. The patient participant was assessed using an 11-point scale. Participants who reported >5 were allocated to the "participation" group, and those who reported ≤5 were allocated to the "nonparticipation" group. A 1:1 propensity score matching was conducted. The primary outcome was the desire for more pain treatment. All other items of PROs were the secondary outcomes comprising pain intensity, interference of pain with function, emotional impairment, adverse effects, and other patient perception. From February 2014 to November 2020, 2244 patients from 20 centers were approached, of whom 1804 patients were eligible and 726 pairs were matched. There was no significant difference between the groups in the desire for more pain treatment either before (25.4% vs 28.2%, risk ratio [95% CI]: 0.90 [0.77, 1.05], P = .18) or after matching (26.7% vs 28.8%, risk ratio [95% CI]: 0.93 [0.79, 1.10], P = .43). After matching, patients in the participation group reported significantly better PROs, including pain intensity (less time spent in severe pain [P < .01]), emotional impairment (less anxiety [P < .01]), interference with function (less interference with sleep [P < .01]), adverse effects (less drowsiness [P = .01]), and patient perception (more pain relief [P < .01] and more satisfaction [P < .01]), than the nonparticipation group. Patient participation in pain treatment decisions was associated with improved pain experience but failed to mitigate the desire for more treatment.
Collapse
Affiliation(s)
- Bailin Jiang
- Department of Anesthesiology, Peking University People’s Hospital, Beijing, China
| | - Yaqing Wu
- Department of Anesthesiology, Peking University People’s Hospital, Beijing, China
| | - Xiuli Wang
- Department of Anesthesiology, Peking University People’s Hospital, Beijing, China
| | - Yu Gan
- Department of Anesthesiology, Peking University People’s Hospital, Beijing, China
| | - Peiyao Wei
- Department of Anesthesiology, Peking University People’s Hospital, Beijing, China
| | - Weidong Mi
- Anesthesia and Operation Center, the First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Yi Feng
- Department of Anesthesiology, Peking University People’s Hospital, Beijing, China
- *Correspondence: Yi Feng, Department of Anesthesiology, Peking University People’s Hospital, No. 11 Xizhimen South Street, Xicheng District 100044, Beijing, China (e-mail: )
| |
Collapse
|
10
|
Patient satisfaction with post-operative pain management and associated factors among surgical patients at Tikur Anbessa Specialized Hospital: Cross-sectional study. Ann Med Surg (Lond) 2022; 79:104087. [PMID: 35860062 PMCID: PMC9289483 DOI: 10.1016/j.amsu.2022.104087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 06/23/2022] [Accepted: 06/23/2022] [Indexed: 11/24/2022] Open
Abstract
Background Objective Method Result Conclusion Patient satisfaction with postoperative pain management was suboptimal. ASA status, pain, analgesic techniques & management were significantly associated. Patient satisfaction also associated with empathy, patient education, & communication.
Collapse
|
11
|
BORAN ÖF, GÜNAY O, GÜNAY AE, BORAN M, BİLAL B, BAKACAK M, YAZAR FM, DOLU H, BOZAN MB, BİRADLİ H. Factors affecting perioperative patient satisfaction with regional anesthesia: A patient-centered survey study. CLINICAL AND EXPERIMENTAL HEALTH SCIENCES 2022. [DOI: 10.33808/clinexphealthsci.1136625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objective: To determine the demographic and clinical characteristics that affect patient satisfaction with regional anesthesia.
Methods: This study was conducted at Kahramanmaras Sutcu Imam University Hospital between June-July 2019. The patients were included on a voluntary basis and all had undergone obstetrics, urology, orthopedics, or general surgery, and met the following inclusion criteria: (1) age >18 years, (2) received regional anesthesia, (3) ASA-PS score of ≤ 3, and (4) no cognitive problem that would prevent self-expression. A Personal Information Form and the Evaluation of the Experience of Regional Anesthesia Questionnaire were applied to 402 patients at 48 hours after surgery performed under regional anesthesia in a university hospital in Turkey.
Results: The EVAN-LR total scores were 71.2±15.6 in obstetrics patients, followed by 54.9±24.9 in orthopedic patients, 26.6±24.4 in urology patients and 15.9±7.2 in general surgery patients (p
Collapse
Affiliation(s)
| | | | | | - Maruf BORAN
- Amasya University, Faculty of Medicine, Internal Medicine Intensive Care Unit
| | - Bora BİLAL
- KAHRAMANMARAS SUTCU IMAM UNIVERSITY, SCHOOL OF MEDICINE
| | - Murat BAKACAK
- KAHRAMANMARAS SUTCU IMAM UNIVERSITY, SCHOOL OF MEDICINE
| | | | - Hasan DOLU
- Dr.Ersin Aslan Research and Education Hospital, Department of Anesthesiology and Reanimation
| | | | - Hilal BİRADLİ
- KAHRAMANMARAS SUTCU IMAM UNIVERSITY, SCHOOL OF MEDICINE
| |
Collapse
|
12
|
Wang J, Xu M, Zhang C, Wei D. Clinical analysis of subxiphoid single-port thoracoscopic surgery for simultaneous bilateral lung lesion resection. BMC Surg 2022; 22:203. [PMID: 35614417 PMCID: PMC9131547 DOI: 10.1186/s12893-022-01646-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 04/28/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To investigate the efficacy and safety of simultaneous subxiphoid single-port thoracoscopic resection of bilateral lung lesions. METHODS This retrospective study analyzed the clinical data of 72 patients who underwent resection of bilateral lung lesions at the Department of Thoracic Surgery in the First Affiliated Hospital of University of Science and Technology of China between August 2020 and January 2022. Surgery-related parameters were compared between patients who underwent subxiphoid single-port thoracoscopy (subxiphoid group, 36 patients) and patients who underwent intercostal single-port thoracoscopy (intercostal group, 36 patients). RESULTS Compared to the intercostal group, the subxiphoid group exhibited significantly better postoperative catheterization time (P = 0.013), postoperative thoracic drainage, postoperative visual analog scale pain scores at 24 and 48 h, and incision pain and numbness at 1 and 3 months after surgery (all P < 0.05). There were no significant differences in operation time, intraoperative blood loss, or postoperative complications between the two groups (all P > 0.05). There were no cases of perioperative mortality, conversion to thoracotomy, or serious complications in either group. CONCLUSION Subxiphoid single-port thoracoscopic surgery for simultaneous resection of bilateral lung lesions is safe and effective, reduces postoperative acute and chronic pain, decreases trauma, allows faster recovery, and is more consistent with the concept of minimally invasive surgery than bilateral intercostal single-port thoracoscopy. Thus, this subxiphoid single-port thoracoscopic surgery approach should be considered for clinical application.
Collapse
Affiliation(s)
- Jun Wang
- Department of Thoracic Surgery, The First Affiliated Hospital of University of Science and Technology of China, Hefei, 230001, People's Republic of China.
| | - Meiqing Xu
- Department of Thoracic Surgery, The First Affiliated Hospital of University of Science and Technology of China, Hefei, 230001, People's Republic of China
| | - Chuankai Zhang
- Department of Thoracic Surgery, The First Affiliated Hospital of University of Science and Technology of China, Hefei, 230001, People's Republic of China
| | - Dazhong Wei
- Department of Thoracic Surgery, The First Affiliated Hospital of University of Science and Technology of China, Hefei, 230001, People's Republic of China
| |
Collapse
|
13
|
Evaluation of the Postoperative Nursing Effect of Thoracic Surgery Assisted by Artificial Intelligence Robot. CONTRAST MEDIA & MOLECULAR IMAGING 2021; 2021:3941600. [PMID: 34867111 PMCID: PMC8610671 DOI: 10.1155/2021/3941600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 10/27/2021] [Indexed: 12/01/2022]
Abstract
In order to evaluate the postoperative nursing effect of artificial intelligence robot-assisted thoracic surgery, this study proposed the Da Vinci robot-assisted pulmonary lobotomy, from January to December 2014; 42 patients (15 males and 27 females, aged 33–69 years old) underwent lobectomy with the Da Vinci robot system in the chest hospital. A series of postoperative nursing was carried out. The surgical results showed that 42 patients with Da Vinci robot-assisted lobectomy had operation time of 62–225 min and blood loss of 70–300 mL. There was no intraoperative blood transfusion, the intraoperative central rate was maintained at 60–100 times/min, and the blood pressure was maintained at 90–140/60–90 mmHg. No patient was transferred to thoracotomy, and 2 patients were performed robotic wedge resection first, and then, robotic lobectomy was performed after malignant tumor was confirmed by freezing results, with relatively light postoperative pain, no infection, beautiful wound, and smooth recovery and discharge. Robot-assisted lobectomy is a new technique with advantages of less trauma, less pain, faster recovery, and safer and more thorough lymph node dissection.
Collapse
|
14
|
Does thoracic epidural anaesthesia constitute over-instrumentation in video- and robotic-assisted thoracoscopic lung parenchyma resections? Curr Opin Anaesthesiol 2021; 34:199-203. [PMID: 33630772 DOI: 10.1097/aco.0000000000000975] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Effective and sustained perioperative analgesia in thoracic surgery and pulmonary resection is beneficial to patients by reducing both postoperative pulmonary complications and the incidence of chronic pain. In this review, the indication of thoracic epidural anaesthesia in video- (VATS) and robotic-assisted (RATS) thoracoscopy shall be critically objectified and presented in a differentiated way. RECENT FINDINGS Pain following VATS and RATS has a negative influence on lung function by inhibiting deep respiration, suppressing coughing and secretion and favours the development of atelectasis, pneumonia and other postoperative pulmonary complications.In addition, inadequate pain therapy after these procedures may lead to chronic pain. SUMMARY Since clear evidence-based recommendations for optimal postoperative analgesia are still lacking in VATS and RATS, there can be no universal recommendation that fits all centres and patients. In this context, thoracic epidural analgesia is the most effective analgesia procedure for perioperative pain control in VATS and RATS-assisted surgery for patients with pulmonary risk factors.
Collapse
|
15
|
Pro: thorakale Periduralanästhesie bei videoassistierter Thorakoskopie. Anaesthesist 2020; 69:758-759. [DOI: 10.1007/s00101-020-00841-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
16
|
Chen J, Volpi S, Ali JM, Aresu G, Wu L, Chen Z, Wang J, Chen B, Yang C, Soultanis KM, Jiang G, Jiang L. Comparison of post-operative pain and quality of life between uniportal subxiphoid and intercostal video-assisted thoracoscopic lobectomy. J Thorac Dis 2020; 12:3582-3590. [PMID: 32802437 PMCID: PMC7399408 DOI: 10.21037/jtd-20-425] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Background Uniportal video-assisted thoracoscopic surgery (VATS) although considered less invasive than the multi-port techniques, is still an intercostal approach, resulting in intercostal nerve injury. Recently, some surgeons have tried to address this problem by attempting a subxiphoid approach. The aim of our study was to assess and compare results between intercostal and subxiphoid uniportal VATS lobectomy in terms of postoperative pain and quality of life (QoL). Methods Patients from January 2014 to January 2018 undergoing subxiphoid and intercostal VATS lobectomy were prospectively assessed for pain and QoL at 1, 3, and 6 months following discharge. Postoperative pain was measured using a numeric rating scale (NRS) and QoL was assessed with the EuroQoL 5-dimension questionnaire (EQ5D) Results Eight hundred and thirty-three patients undergoing lobectomy were included: 373 in the intercostal VATS group and 459 in the subxiphoid group. The proportion of patients with moderate or worse clinical pain was significantly lower at 1 and 3 months after subxiphoid VATS (P<0.01) compared with intercostal VATS. QoL was significantly higher following subxiphoid VATS at these same time points (P<0.001). Conclusions Uniportal subxiphoid VATS is a safe and feasible minimally invasive approach for undertaking pulmonary lobectomy that may result in reduced postoperative pain compared to conventional VATS. There may also be earlier return of QoL. A randomized controlled trial examining this further would provide further insight into our observations.
Collapse
Affiliation(s)
- Jian Chen
- Department of Thoracic surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, China
| | - Sara Volpi
- Department of Cardiothoracic Surgery, The Royal Papworth Hospital, Cambridge, UK
| | - Jason M Ali
- Department of Cardiothoracic Surgery, The Royal Papworth Hospital, Cambridge, UK
| | - Giuseppe Aresu
- Department of Cardiothoracic Surgery, The Royal Papworth Hospital, Cambridge, UK
| | - Liang Wu
- Department of Thoracic surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, China
| | - Zhigang Chen
- Department of Thoracic surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, China
| | - Jin Wang
- Department of Thoracic surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, China
| | - Bei Chen
- Department of Thoracic surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, China
| | - Chenlu Yang
- Department of Thoracic surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, China
| | - Kostis Marios Soultanis
- Department of Thoracic surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, China
| | - Gening Jiang
- Department of Thoracic surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, China
| | - Lei Jiang
- Department of Thoracic surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, China
| |
Collapse
|
17
|
Meissner W, Zaslansky R. A survey of postoperative pain treatments and unmet needs. Best Pract Res Clin Anaesthesiol 2019; 33:269-286. [PMID: 31785713 DOI: 10.1016/j.bpa.2019.10.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 10/02/2019] [Accepted: 10/04/2019] [Indexed: 12/12/2022]
Abstract
More than 300 million patients undergo surgery worldwide each year. Pain associated with these procedures is associated with short- and long-term negative sequelae for patients, healthcare providers, and healthcare systems. The following chapter is a review of the reality of postoperative pain management in everyday clinical routine based on survey- and registry-derived data with a focus on care in adults. Between 30% and up to 80% of patients report moderate to severe pain in the days after surgery. Structures, processes, and outcomes vary widely between hospitals and indicate gaps between evidence-based findings and practice. Pain assessment is not effectively implemented in many hospitals and should consider cultural differences. Few data exist on the situation of pain management in low- and middle-income countries, indicating lack of resources and available medication in many of these areas. Certain types of surgery as well as demographic and clinical factors are associated with increased risk of severe postoperative pain.
Collapse
Affiliation(s)
- Winfried Meissner
- Dept of Anesthesiology and Intensive Care, Jena University Hospital, Am Klinikum 1, 07740 Jena, Germany.
| | - Ruth Zaslansky
- Dept of Anesthesiology and Intensive Care, Jena University Hospital, Am Klinikum 1, 07740 Jena, Germany
| |
Collapse
|
18
|
Affiliation(s)
- Honorio T Benzon
- From the Departments of Anesthesiology, Northwestern University Feinberg School of Medicine, Chicago, IL; University of Virginia School of Medicine, Charlottesville, VA; and McGill University, Montreal, Quebec, Canada
| | | | | |
Collapse
|