A survey of postoperative epidural and intravenous analgesia in Greece.
OBJECTIVE
Epidural and intravenous analgesia are widely used for postoperative pain management. Efficacy and safety is enhanced with the establishment of acute pain services. We studied the terms of application of these techniques in Greek hospitals and compared practices between anaesthetic departments with or without acute pain services.


METHODS
We performed a postal survey regarding departmental policy on the application of epidural and intravenous analgesia, patient monitoring, audit and educational activities, acute pain service teams and proposals for improvement. Pain services were classified according to predetermined quality criteria. Hospitals with or without acute pain services were compared.


RESULTS
Response rate was 46.3% (51 of 110 departments). Epidural analgesia was used in 49 departments, equally applied as intermittent boluses or continuous infusion. Twenty-two of the 39 departments that were using continuous infusion, used exclusively a lumbar approach. Intravenous analgesia was used by 42 (82%) departments; 13 used exclusively continuous infusion. All eight departments that had an established acute pain service fulfilled the predefined quality criteria compared with only ten of the remaining 43 (P < 0.001).


CONCLUSIONS
Our study discloses important issues regarding the use of intravenous and epidural analgesia and postoperative patient monitoring in Greek hospitals. Implementation of acute pain services that are satisfying the quality criteria may help to improve patient care.
General Hospital of Nikea Pireaus, Department of Anaesthesiology, Iraklion, Athens, Greece. ptzavellas@yahoo.gr
P
P
Tzavellas
K
K
Papilas
I
I
Grigoropoulou
C
C
Zolindaki
P
P
Kouki
H
H
Chrona
G
G
Kostopanagiotou
D015360:Analgesia, Epidural / Q000706:statistics & numerical data*; D016058:Analgesia, Patient-Controlled; D000700:Analgesics / Q000008:administration & dosage*; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D000932:Antiemetics / Q000627:therapeutic use; D004363:Drug Utilization; D006115:Greece; D019538:Health Care Surveys; D006276:Health Facility Size; D006801:Humans; D007275:Injections, Intravenous; D018710:Pain Clinics; D010149:Postoperative Pain / Q000145:classification / Q000188:drug therapy*; D011795:Surveys and Questionnaires
D000700:Analgesics; D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000932:Antiemetics