Analgesic administration, pain intensity, and patient satisfaction in cardiac surgical patients.
BACKGROUND
Pain can adversely affect a patient's physiological and psychological recovery, yet little is known about the pain experience of cardiac surgical patients.


OBJECTIVE
To examine nursing practice regarding analgesic administration and measure pain intensity and patient satisfaction with pain management practices.


METHODS
To establish baseline nursing practice regarding analgesic administration, charts were reviewed retrospectively in 50 adult cardiac surgical patients, and the same information was collected concurrently for a prospective sample of 51 patients. The subjects completed visual analogue scales as a measure of pain intensity twice daily while in the cardiothoracic intensive care unit and Pain Relief Satisfaction Questionnaires on the day after transfer from the unit.


RESULTS
Patients in the prospective group received significantly more analgesia. Pain intensity was moderate (4 or greater on the Visual Analogue Scale). Women had higher overall visual analogue scale scores than did men, 4.57 versus 3.70. Patients in whom an internal mammary artery had been used as a bypass graft had significantly higher scores compared with patients with vein grafts. The Pain Relief Satisfaction Questionnaire responses indicated that 96% of the patients experienced effective pain management in the cardiothoracic intensive care unit.


CONCLUSIONS
Despite receiving analgesic doses twice those reported elsewhere for similar populations, the patients in this study reported moderate pain intensity. This finding was confounded by the fact that 96% expressed satisfaction with their pain management in the cardiothoracic intensive care unit. Frequent assessment and documentation of both pain and pain relief from interventions are necessary if the healthcare team is to implement an individualized analgesic regimen.
Meehan
D A
DA
Cardiothoracic Intensive Care Unit, UCLA Medical Center, Los Angeles, Calif., USA.
McRae
M E
ME
Rourke
D A
DA
Eisenring
C
C
Imperial
F A
FA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000008:administration & dosage*; D000701:Analgesics, Opioid / Q000627:therapeutic use; D006348:Cardiac Surgical Procedures; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy* / Q000451:nursing / Q000503:physiopathology; D017060:Patient Satisfaction; D011446:Prospective Studies; D012189:Retrospective Studies; D012737:Sex Factors
D000700:Analgesics; D000701:Analgesics, Opioid