title: [A national survey of postoperative pain management in France: influence of type of surgical centres].
abstract: BACKGROUND
  The French Society of Anaesthesia and Intensive Care has supported a national survey of postoperative pain (POP) management in various type of surgical centres.
  
  
  METHODS
  The survey was cross-checking data on information, evaluation, treatment concerning POP of adult patient within 24h after surgery in surgical centres randomly selected according to teaching status, public or private funding and size. A local anaesthetist referent provided information on management of POP.
  
  
  RESULTS
  One thousand and nine hundred adult patients were audited. Information on POP was better understood in private centres. Rarely prescribed, written evaluation of POP was frequent on the ward (>90%) without any difference between centres. In all centres, POP evaluation tool were by decreasing frequency, numerical scale, nonspecific tool, visual analog scale and verbal scale. In all institutions, pain was rarely a criterion for recovery room discharge. Reported POP was mild at rest, moderate when moving and intense for maximal pain with no difference between centres. Incidence of side-effects was similar in all centres according to patient or chart, with mainly nausea and vomiting. Analgesics were frequently started during anaesthesia. Patient-controlled analgesia was used less frequently than subcutaneous morphine whose prescription frequently did not follow guidelines especially in small hospital. Non opioid analgesic included paracetamol, ketoprofen mainly in private structure and nefopam mainly in university hospital. Epidural or peripheral nerve blocks were underused similarly in all centres. Evaluation or treatment protocols were less frequent in university hospital.
  
  
  CONCLUSIONS
  This national, prospective, patient-based, observational survey reveals similar achievements in different surgical centres but also some differences and persistent challenges for POP management.
authors: Service d'anesthésie-réanimation chirurgicale, université de Versailles-St-Quentin, hôpital Raymond-Poincaré, AP-HP, 104, boulevard Raymond-Poincaré, 92380 Garches, France. dominique.fletcher@rpc.ap-hop-paris.fr
authors: D
authors: D
authors: Fletcher
authors: A
authors: A
authors: Mardaye
authors: C
authors: C
authors: Fermanian
authors: P
authors: P
authors: Aegerter
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000628:therapy*; D013531:Surgicenters / Q000145:classification*; D011795:Surveys and Questionnaires; D055815:Young Adult