title: Pre-operative analgesia in the accident and emergency department.
abstract: OBJECTIVE
  To evaluate the adequacy of pre-operative analgesia and patient's satisfaction at the accident and emergency department, in terms of pain relief.
  
  
  METHODS
  Observational study.
  
  
  METHODS
  The Accident and Emergency Department (A&E) of Civil Hospital, Karachi, during April and May, 2007.
  
  
  METHODS
  Patients presenting with acute abdomen or tauma were included. Visual Analogue Scale (VAS) was used to grade severity of pain. Pain at presentation, analgesic prescribed, post-analgesic residual pain and patient satisfaction were assessed.
  
  
  RESULTS
  A total of 166 patients (109 males and 57 females) were enrolled in the study. It included 98 (59%) cases of trauma and 68 (41%) patients with acute abdomen. Mean pain score was 6.95+/-2.03 on VAS. Female patients (p=0.008) and patients with acute abdomen (p<0.001) experienced significantly more pain as compared to male and trauma patients respectively. Analgesics were prescribed to 104 (62.7%) patients. Post-analgesic mean residual pain score was 5.0+/-1.8. Out of them, 47.1% patients waited to be given more analgesia. There was significant less prescription of analgesic to patients with acute abdomen (52.9%) as compared to trauma patients (26.5%) (p=0.001). Overall, more than half of the patients (59.6%) were not satisfied with the pre-operative analgesic treatment in the A&E department.
  
  
  CONCLUSIONS
  Pre-operative analgesia was underprescribed and pain was undertreated in accident and emergency department resulting in more than half patients being not satisfied.
authors.affiliation: Department of Surgery, Dow University of Health Sciences and Civil Hospital, Karachi. masood@masoodjawaid.com
authors.forename: Masood
authors.initials: M
authors.lastname: Jawaid
authors.forename: Zubia
authors.initials: Z
authors.lastname: Masood
authors.forename: Tarique Kamal
authors.initials: TK
authors.lastname: Ayubi
mesh_terms: D000006:Abdomen, Acute / Q000601:surgery*; D000059:Accidents / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000698:Analgesia / Q000379:methods*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D017060:Patient Satisfaction; D011300:Preoperative Care / Q000379:methods*; D011446:Prospective Studies; D012737:Sex Factors; D013997:Time Factors; D014947:Wounds and Injuries / Q000601:surgery*; D055815:Young Adult