[Surgical pain management. A Germany-wide survey including the effect of clinical guidelines].
BACKGROUND
Over the last few years, various studies have aimed at improving the diagnosis and therapy of perioperative and posttraumatic pain.


METHODS
In an anonymous postal survey, 2,393 German surgical clinics were asked to describe several aspects of their clinical pain treatment. In order to assess the influence of interdisciplinary guidelines on surgical pain therapy, the results of this survey were compared to a survey from 1997.


RESULTS
The response rate was 30.8% ( n=738). Pain was measured quantitatively in 11.4% ( n=80) of hospitals, a figure which is unchanged since 1997. In pain treatment,however, some changes were discernible: while 46.6% of all hospitals in 1997 used patient-controlled analgesia often or occasionally, this proportion has risen to 64.5%.Both, the national acute pain guidelines and the WHO chronic pain guidelines were well known (71.3% and 74.7%) and accepted (98.8% and 98.5%, respectively). Among those surgeons who knew the national guidelines,93.7% reported that they used them clinically. In 149 hospitals (20.2%), local guidelines have been developed either anew or from existing guidelines.


CONCLUSIONS
Although clinical guidelines are widely used, pain therapy in surgical patients has improved only marginally.
Neugebauer
E
E
Biochemische und Experimentelle Abteilung, II.Chirurgischer Lehrstuhl, Universität zu Köln. Cologne. sekretariat-neugebauer@uni-koeln.de
Sauerland
S
S
Keck
V
V
Simanski
C
C
Witte
J
J
D000208:Acute Disease; D000698:Analgesia / Q000379:methods*; D016058:Analgesia, Patient-Controlled; D000700:Analgesics / Q000627:therapeutic use*; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D005858:Germany; D019538:Health Care Surveys; D006801:Humans; D010146:Pain / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D010149:Postoperative Pain / Q000175:diagnosis / Q000188:drug therapy*; D017410:Practice Guidelines as Topic; D011795:Surveys and Questionnaires; D014944:World Health Organization; D014947:Wounds and Injuries / Q000150:complications
D000700:Analgesics; D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal