title: A multicentre survey of the current acute post-operative pain management practices in tertiary care teaching hospitals in Maharashtra.
abstract: OBJECTIVE
  Undertreated pain can have negative consequences on patients' health as well as the health-care system. The present study was aimed at identifying the current trends in post-operative pain management and availability of acute pain services (APS). In addition, it is also an attempt to assess the availability of analgesia for non-surgical cases, and the attitudes, beliefs, and perceptions of clinicians regarding acute pain management in the tertiary hospitals in the state of Maharashtra (India).
  
  
  METHODS
  This was a cross-sectional, multicentre questionnaire survey involving the anaesthesiologists and surgeons. Percentages, median, interquartile ranges were calculated and compared by employing a Wilcoxon sign rank test.
  
  
  RESULTS
  Data from thirty centres revealed that the surgeons played a major role in treating pain, while most of the anaesthesiologists treated pain primarily in the operation theatre and recovery room. An APS was operational in seven hospitals. The most frequently employed techniques to achieve analgesia were the administration of non-steroidal anti-inflammatory drugs, opioids and epidural analgesia. The majority of the centres had no written protocol and dedicated staff for pain management, pain assessment was not adequately stressed, and only five out of the thirty centres included in the study provided ongoing pain education to health professionals even when the hospitals claimed to provide APS. The major hurdles in providing optimal analgesia and implementing APS were a lack of pain education, equipment and administrative problems.
  
  
  CONCLUSIONS
  Thus, the tertiary centres in Maharashtra fall short of providing optimal acute post-operative pain management.
authors.affiliation: Department of Anaesthesiology, Government Medical College, Aurangabad, India.
authors.forename: Samina Khaliloddin
authors.initials: SK
authors.lastname: Khatib
authors.affiliation: Department of Orthopaedics, Mahatma Gandhi Institute of Health Sciences, Mumbai, Maharashtra, India.
authors.forename: Syed Shamim
authors.initials: SS
authors.lastname: Razvi
authors.affiliation: Department of Anaesthesiology, Government Medical College and Cancer Hospital, Aurangabad, India.
authors.forename: Sadhana Sudhir
authors.initials: SS
authors.lastname: Kulkarni
authors.affiliation: Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Hospital, Mumbai, Maharashtra, India.
authors.forename: Swapnil
authors.initials: S
authors.lastname: Parab
keywords: Acute pain; acute pain service; acute post-operative pain; multimodal analgesia