Abstract: Aims: Patients who are hospitalized often experience a high incidence of postoperative discomfort. The treatment provided by hospitals is influenced by various therapeutic traditions and the attitudes of their respective medical staff. This study aims to investigate the prescription and utilization of analgesic medicines for postoperative pain management. Its objective is to determine the prevalence and severity of postoperative pain, as well as the variations in pain management.
Methods: The research encompassed a descriptive cross-sectional analysis of drug utilization within a sample. The participants consisted of a randomly selected group of consecutive patients who underwent abdominal surgery and were admitted to the Department of General Surgery, Sree Lakshmi Narayana Institute of Medical Sciences, Puducherry from January 2017 to December 2017. Prospective data was collected for each patient regarding the surgical approach employed and the administration of analgesics. The intensity of pain was assessed on the first day following surgery using a visual analog scale (VAS) and a six-point scale ranging from "none" to "intolerable."
Results: The study included a total of 950 patients, with 547 of them being male. The most commonly performed surgical operations were inguinal hernia repair (315, 32%), cholecystectomy (268, 27%), appendectomy (140, 14%), bowel resection (137, 14%), and stomach surgery (58, 6%). Out of the total number of patients, 59% (587) were exclusively prescribed nonopioid analgesics, 9% (89) were exclusively prescribed opioid analgesics, and 27% (263) were prescribed both opioid and nonopioid analgesics. The drugs that were administered most commonly were methizole, which was given to 667 patients, and pethidine, which was given to 213 patients. While the majority of physician instructions included the scheduling of analgesic administration, the majority of actual doses were delivered on an as-needed basis. The mean daily administration of analgesics was found to be lower than the recommended dosages. 371 out of 967 patients, which accounts for 38 percent, experienced severe to dreadful maximal pain on the first day. Significant interhospital variance was observed in the surgical techniques performed, the analgesics supplied, and the pain scores recorded by patients. The prevalence of acute or excruciating pain among patients in each facility ranged from 22% to 67%.
Conclusions: The persistent occurrence of substantial pain among patients in India following abdominal surgery can be attribuxted to the inadequate utilization of analgesics. Significant disparities were seen among institutions in the management and frequency of postoperative pain.
