Aims A fast-track based surgical treatment reduces morbidity and hospital stay by providing early mobilization. Sufficient postoperative pain management is mandatory for early mobilization and optimal utilization of rehabilitation measures. Insufficient postoperative pain management is however a widespread problem. Lack of knowledge about pain and pain treatment among health care professionals and general community has been considered as a major potential contributor in insufficient pain management. It has been suggested that severe postoperative pain might imply a potential risk of developing chronic pain. The purpose of this study was to examine this problem in acute and elective surgical patients in department of orthopedic surgery at Bispebjerg Hospital in order to identify obstacles and possibilities for future improvement. Methods Questionnaires were developed and distributed to patients consisted of 10 acute admitted and 10 elective orthopedic patients. The patients’ pain scores were recorded with a 0–10 NRS scale. The scores were obtained for current pain in rest, current pain in activity, and the highest and lowest pain intensity for the last 24 hours. Data were handled using descriptive statistics. Results The goal for sufficient pain treatment was patients with pain score at ≤ 3 NRS at rest and ≤ 5 in activity. For pain at rest 45% of the patients were within the goal range and 55% for the current pain in activity. For the mildest pain experienced in the last 24 h, 75% and for the worst pain experienced 30% of the patients reached the goal. Conclusions Corresponding to similar studies, half of the patients received a sufficient pain treatment at the time of examination. The consequences for insufficient pain management would be reduced effect of the physiotherapy, reduced ability to handle every day activity, sleep disturbances, and potential risk of developing chronic pain.

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AimsThe incidence of persistent post-operative pain (PPP) is 30–85% in lower limb amputee (LLA) patients and identification of preoperative risk factors are warranted. Preoperative levels of anxiety, depression, pain catastrophizing, neuropathic pain and severe preoperative pain have previously been linked with PPP but such screening tools are not used in the clinical hospital setting. The aim of this study was to assess feasibility of using questionnaires for anxiety, depression, pain catastrophizing, neuropathic pain and preoperative pain levels in a clinical preoperative setting.MethodsPatients scheduled for non-traumatic amputation of the lower leg or femur were recruited from three Danish hospitals. Exclusion criteria were surgery 4-weeks prior to LLA, same leg re-amputation, or inability to participate. Pre-operative values of anxiety, depression and catastrophizing were assessed using the Hospital Anxiety (A) and Depression(D) Scale (HADS) (cutoff: 8) and Pain Catastrophizing Scale (PCS) (cutoff =32). Neuropathic pain was assessed preoperatively using Pain-Detect-Questionnaire (PD-Q) (cutoff: 19). The maximum preoperative pain intensity was assessed using the Numeric Rating Scale (NRS; 0: no pain and 10: worst imaginable pain). Scores are presented as median values with interquartile range (Q1–Q3).ResultsEight of 18 patients (5 females) completed this pilot study: median age 71 (range 56–83), 6 femur and two lower leg amputees. Nine of ten excluded patients were unable to complete the questionnaires and one patient was operated acutely. Median pre-operative HADS-D and -A scores were 7 (3–9, 50% ≥ cutoff) and 4 (1–8, 25% ≥ cutoff), pre-operative PCS score was 24 (18–28, 13% ≥ cutoff), pre-operative PD-Q score was 16 (8–22, 50% ≥ cutoff) and NRS score was 9.5 (8–10).ConclusionsThis study indicates that it is possible to implement preoperative questionnaires in a clinical setting. However, more than 50% of the patients are unable to complete the questionnaires.