Postoperative analgesia: economics, resource use, and patient satisfaction in an urban teaching hospital.
We sought to describe the economic and humanistic burden after total abdominal hysterectomy (TAH), total hip replacement (THR), or total knee replacement (TKR) surgery. Resource use and costs were estimated from the hospital perspective. The mean worst pain severity was 8.9, 8.1, and 7.6 on a 0- to 10-point scale after TAH, THR, and TKR, respectively. Postoperative pain was worst on postoperative day 1 after TAH or THR, and on postoperative day 2 after TKR. Analgesic medications relieved from 60% to nearly 78% of postoperative pain, but participants re- ported moderate-to-high levels of interference with general activity, walking ability, and sleep because of postoperative pain. Most costs were attributed to the hospital admission and operating room. The average length of hospitalization was 2.8 days after TAH, and 3.9 days after THR or TKR. This study provides insight into patients' experience with pain after common surgeries, perioperative costs, and medical resource use.


CONCLUSIONS
Despite impressive relief with analgesics, postoperative pain interferes with patients' ability to sleep, walk, and participate in other activities. Medications used postoperatively account for a small portion of total costs. Satisfaction ratings alone are a poor indicator of pain control. These data can be used to help improve pain relief.
Strassels
Scott A
SA
Department of Pharmacy, University of Washington, Seattle, Washington 98195, USA. scotts1@u.washington.edu
Chen
Connie
C
Carr
Daniel B
DB
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use; D000701:Analgesics, Opioid / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000191:economics; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000191:economics; D001294:Attitude to Health; D005260:Female; D006295:Health Resources / Q000706:statistics & numerical data*; D017721:Hospital Costs; D006784:Hospitals, Teaching; D006786:Hospitals, Urban; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects / Q000191:economics; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy / Q000191:economics*; D017060:Patient Satisfaction
D000700:Analgesics; D000701:Analgesics, Opioid