Quality of Postoperative Pain Management Following Thoracic Surgery: a Prospective Observational Study.
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 250
- 试验地点
- 1
- 主要终点
- Pain relief according to analgesic technique
研究概览
简要总结
The purpose of this study is to assess the quality of postoperative pain management in a Canadian teaching hospital following thoracic surgery.
Hypothesis: Postoperative pain management following thoracotomy or thoracoscopy is still suboptimal despite the evidence that adequate pain relief improves outcome.
详细描述
Pain is an expected outcome of surgery. However, many patients experience suboptimally managed postoperative pain. Benefits of adequate analgesia no longer need to be demonstrated. Optimal analgesia leads to faster recovery, reduces the risk of postoperative complications, enhances patient's satisfaction and quality of life following surgery.
Currently, approximately 1000 thoracic surgeries are performed in our hospital annually. Many of these surgeries that previously required a thoracotomy incision are now performed under Video-Assisted Thoracoscopy Surgery (VATS). Although VATS is known to be less invasive and causes less pain than thoracotomy, some patients still experience considerable pain following thoracoscopy especially during the first hours following surgery.
Thoracic epidural has emerged as the preferred pain control technique following thoracotomy. However, the role of epidural analgesia after thoracoscopy remains debatable. The ideal postoperative analgesia regimen for the short-duration but intense pain related to thoracoscopy has not been elucidated. Paravertebral blockade is an alternative to epidural analgesia. However, the duration of pain relief associated with this technique may vary from 4 to 48 hours. Systemic opioids given through patient-controlled devices may be used after thoracic surgery but the analgesic effect can be limited and undesirable side-effects may occur.
This prospective observational study will investigate the quality of pain management following thoracic surgery and assess patient's and nurse's satisfaction regarding pain relief in a teaching hospital.
Methods:
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 80 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Consenting patients aged 18-80 years
- •ASA physical status 1-3
- •Patients undergoing elective thoracic surgery (thoracotomy/thoracoscopy)
排除标准
- •Current regular use of drugs belonging to the class of opioids
- •Presence of a coexisting chronic pain syndrome
- •The inability to understand a verbal numeric pain scale (VNS) despite previous instruction
- •Patient refusal
结局指标
主要结局
Pain relief according to analgesic technique
时间窗: From surgery (Day 0) until discharge from the hospital (Day 5)
次要结局
- Consumption of analgesics(From surgery (Day 0) until discharge from the hospital (Day 5))
- Interference of pain on daily activities(From surgery (Day 0) until discharge from the hospital (Day 5))
- Patient's satisfaction with pain relief(From surgery (Day 0) until discharge from the hospital (Day 5))
- Length of stay in the recovery room(From arrival (Day 0) until discharge from the recovery room (Day 0))
- Nurse's satisfaction with patient's pain relief, mobility and collaboration(From surgery (Day 0) until discharge from the hospital (Day 5))
- Length of stay in the step-down unit(From arrival (Day 0) until discharge from the step-down unit (Day 1))
- Length of stay in the hospital(From surgery (Day 0) until discharge from the hospital (Day 5))
- Side-effects attributable to analgesia(From surgery (Day 0) to discharge from the hospital (Day 5))
- Presence of postoperative complications(From surgery (Day 0) until discharge from the hospital (Day 5))