TY - JOUR

T1 - Waking Up in Pain: a prospective unselected cohort study of pain in 3702 patients immediately after surgery in the Danish Realm

AU - Rasmussen, Anders Mølgaard

AU - Toft, Mette Helene

AU - Awada, Hussein Nasser

AU - Dirks, Jesper

AU - Brandsborg, Birgitte

AU - Rasmussen, Line Kirkegaard

AU - Kirkegaard, Ellen

AU - Hasfeldt-hansen, Dorthe

AU - Larsen, Thomas Egemose

AU - Charalampidis, Georgios

AU - Mørk, Emilie Louise Schjøtt

AU - Rosager, Chirstine Linaa

AU - Salam, Idress Ahmad

AU - Rasmussen, Bodil Steen

AU - Jørgensen, Marlene

AU - Skjønnemand, Martin

AU - Lund, Caterina Amanti

AU - Schroder, Save

AU - Sørensen, Johan Kløvgaard

AU - Sølling, Christoffer

AU - Hansen, Kristian Kraft

AU - Rasmussen, Christina Kirkegaard

AU - Steen, Nick Phaff

AU - Nielsen, Anne Staal

AU - Geisler, Anja

AU - Køppen, Kasper Storm

AU - Pælestik, Maria Bolther

AU - Grøfte, Thorbjørn

AU - Meyhoff, Christian Sylvest

AU - Kroh, Charlotte Loumann

AU - Christensen, Amalie Prien

AU - Haugstvedt, Aleksander Fjeld

AU - Hansen, Maria Aagaard

AU - Nielsen, Christian Viggo

AU - Dybdal, Bitten

AU - Falcon, Lars

AU - Hägi-pedersen, Daniel

AU - Jauho, Kristian

AU - Wolsted, Henrik

AU - Pedersen, Christian Alves Kohler

AU - Sommer, Trine Nyboe

AU - Kromberg, Laurits Schou

AU - Kristensen, Danja Lykke

AU - Svensson, Camilla Kara

AU - Nielsen, Hans Fjeldsøe

AU - Sørensen, Martin Kryspin

AU - Jacobsen, Stig

AU - Sundskard, Martin

AU - Brahe, Nicole

AU - Jakobsen, Karina

AU - Jensen, Mette Skov

AU - Odder, Lillian

AU - Selter, Hansjörg

AU - Mohr, Tróndur Høgnason

AU - Jensen, Elin H

AU - Jensen, Pernille Pia

AU - Skjold, Christine

AU - Aasvang, Eske Kvanner

PY - 2021

Y1 - 2021

N2 - Background Acute and persistent pain after surgery is well described. However, no large-scale studies on immediate postoperative pain in the operating room (OR) exist, hindering potential areas of research to improve clinical outcomes. Thus, we aimed to describe the occurrence and severity of immediate postoperative pain in a large, unselected cohort.Methods This was a prospective cohort study, encompassing all procedures in 31 public hospitals in the Danish Realm, during a 5-day period including the weekend. Data on procedures and anesthesia were collected and the main outcome was occurrence of moderate or severe pain in the OR. Secondary outcomes included pain, sedation and nausea in the OR or during the first 15 min in the postanesthesia care unit (PACU) including relevant risk factors. Descriptive and logistic regression statistics were used.Results A total of 3675 procedures were included for analysis (87% inclusion rate). Moderate or severe pain occurred in 7.4% (95% CI 6.5% to 8.3%) of cases in the OR immediately after awakening, rising to 20.2% in the OR and/or PACU. Large intraprocedure and interprocedure variations occurred (0.0%–37.5%), and in 20% of cases with epidural-general anesthesia patients experienced moderate or severe pain. Independent risk factors were female sex, younger age, preoperative pain, daily opioid use and major surgical procedures.Conclusion Moderate or severe pain in the immediate postoperative phase occurred in 20% of all cases with procedure and anesthesiological technique variations, suggesting a need for identification of relevant procedure-specific risk factors and development of preventive treatments.

AB - Background Acute and persistent pain after surgery is well described. However, no large-scale studies on immediate postoperative pain in the operating room (OR) exist, hindering potential areas of research to improve clinical outcomes. Thus, we aimed to describe the occurrence and severity of immediate postoperative pain in a large, unselected cohort.Methods This was a prospective cohort study, encompassing all procedures in 31 public hospitals in the Danish Realm, during a 5-day period including the weekend. Data on procedures and anesthesia were collected and the main outcome was occurrence of moderate or severe pain in the OR. Secondary outcomes included pain, sedation and nausea in the OR or during the first 15 min in the postanesthesia care unit (PACU) including relevant risk factors. Descriptive and logistic regression statistics were used.Results A total of 3675 procedures were included for analysis (87% inclusion rate). Moderate or severe pain occurred in 7.4% (95% CI 6.5% to 8.3%) of cases in the OR immediately after awakening, rising to 20.2% in the OR and/or PACU. Large intraprocedure and interprocedure variations occurred (0.0%–37.5%), and in 20% of cases with epidural-general anesthesia patients experienced moderate or severe pain. Independent risk factors were female sex, younger age, preoperative pain, daily opioid use and major surgical procedures.Conclusion Moderate or severe pain in the immediate postoperative phase occurred in 20% of all cases with procedure and anesthesiological technique variations, suggesting a need for identification of relevant procedure-specific risk factors and development of preventive treatments.

U2 - 10.1136/rapm-2021-102583

DO - 10.1136/rapm-2021-102583

M3 - Journal article

C2 - 34408068

VL - 46

SP - 948

EP - 953

JO - Regional Anesthesia and Pain Medicine

JF - Regional Anesthesia and Pain Medicine

SN - 1098-7339

IS - 11

ER -