[Quality of the postoperative course and patients' satisfaction produced by a system of postoperative pain control: postoperative clinical evidence that influences the quality of the postoperative course].
Acute pain treatment after surgery or trauma, when inadequate, contributes to increased morbidity and prolonged in hospital stay. Acute postoperative pain management can be realised by application of treatment protocols and the regular assessment of the patients clinical conditions. The aim of the ACUTE PAIN SERVICE (APS) is to plan postoperative treatment. According to our experience, besides providing assistance, the APS elaborates results and intervenes through regular audits to improve quality. This system is further enriched through collection of information obtained through an anonymous questionnaire compiled by the patients about forty eight hours after surgery. The questions are expressed such to outline a judgement about patients' satisfaction towards the services supplied by the agency.


OBJECTIVE
Evaluation of effectiveness of pain treatment and level of postoperative wellbeing through continuous observation of the patient.


METHODS
a retrospective study on about 4400 consecutive patients arriving at the APS in the last 2 years of activity, who have been evaluated at fixed moments using various indicators (VAS at rest/activity, PONV and other discomforts).


RESULTS
Follow-up of the patients showed that: - pain relief, when reached, does not conform well-being; - for certain symptoms of discomfort, specific protocols are necessary; - there are correlations between type of surgery, type of anaesthesia and discomfort, which may be reducible through the right attitude in behaviour and therapy; - antalgic therapy itself can cause several side-effects. The solution of the discomfort problem gets close to the concept of perioperative medicine in which APS action goes beyond pain, towards a more complete pain management.
Giunta
F
F
IV U.O. Anestesia e Rianimazione, Azienda Ospedaliera Pisana, Cattedra di Anestesiologia e Rianimazione, Università degli Studi di Pisa, Italy.
Paolicchi
A
A
van Oven
H
H
D005500:Follow-Up Studies; D006801:Humans; D010149:Postoperative Pain / Q000517:prevention & control*; D017060:Patient Satisfaction; D011787:Quality of Health Care; D012189:Retrospective Studies; D011795:Surveys and Questionnaires
Qualità del decorso postoperatorio e soddisfazione del paziente prodotta da un sistema di controllo del dolore postoperatorio. Evidenze cliniche postoperatorie che influenzano la qualità del decorso postoperatorio.