Original Article
Pain Assessment and Management in Patients After Abdominal Surgery From PACU to the Postoperative Unit

https://doi.org/10.1016/j.jopan.2009.03.013Get rights and content

The aim of this exploratory study was to determine the effectiveness of pain relief for surgical patients (N = 52) in transition from the PACU to the postoperative unit. The study also explored whether there was an association between a verbal numeric pain score (0 to 10) on discharge from the PACU and the duration of time until analgesia was administered in the postoperative unit. Information was obtained about pain management, time of discharge, and patient pain scores on discharge from the PACU, as well as pain scores and the time of first analgesic administered in the postoperative unit. Most patients were discharged from the PACU with a pain score in the mild range (0 to 4), indicating reasonable pain relief. An association existed between the pain score on discharge from the PACU and the duration of time to the first analgesic dose administered on the postoperative unit.

Section snippets

Design

An exploratory, descriptive design was used for the study. Approval to conduct the study was obtained from the relevant hospital and university ethics committees.

Subjects and Setting

The study was undertaken in a large, public tertiary hospital comprising 370 acute beds within a network of health facilities consisting of 907 beds in total.17 The hospital is situated in regional Victoria, Australia, with a population of more than 400,000. The region includes a large urban community and many small rural and coastal

Participants

Sixty-eight patients were invited to participate. Four patients declined to participate, which left 64 consenting participants. Of these, 12 were excluded: 10 were using prescribed patient-controlled analgesia, one was discharged home on the day of surgery, and one had a spinal anesthetic. Thus, 52 consenting participants met the inclusion criteria.

Demographic Data

An audit of all patients undergoing laparoscopic cholecystectomy and hernia repair during the study period revealed that the demographic

Discussion

This innovative study provides new information about pain assessment and management as patients move from the PACU to a postoperative unit. Because the findings showed that most patients (75%) were discharged from the PACU with a pain score of 0 to 4, it could be assumed that their pain was managed appropriately. Analgesics administered in the PACU continued to be effective after patients were discharged to the postoperative unit. In addition, the pain scores on discharge from the PACU and the

Conclusion

In this study, lower pain scores on discharge from the PACU were associated with longer times until analgesic was administered in the postoperative unit. Conversely, higher pain scores on discharge from the PACU were associated with shorter times until analgesic was administered in the postoperative unit. The findings arising from this study provide useful information to guide nurses in assessing pain and implementing pain management in PACUs and postoperative units. Nurses in a PACU will be

Jane R. Wilding is the Perioperative Clinical Nurse Educator, Barwon Health, Victoria, Australia.

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  • Cited by (3)

    Jane R. Wilding is the Perioperative Clinical Nurse Educator, Barwon Health, Victoria, Australia.

    Elizabeth Manias is Associate Head (Research) and Equity and Staff Development Coordinator, School of Nursing and Social Work, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia.

    Diarmuid G.L. McCoy is a Consultant Specialist in Anaesthesia and Pain Management, Barwon Health, Victoria, Australia.

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