Dimensions of pain and analgesic administration associated with coronary artery bypass grafting in an Australian intensive care unit

Abstract

This descriptive correlation study evaluated the pain intensity, pain distress and morphine consumption in patients recovering from coronary artery bypass grafting (CABG) surgery in an Australian intensive care unit (ICU) and compared patients' pain intensity ratings with ratings of the nursing staff. Forty‐three patients and their attending nurses rated patients' pain intensity and pain distress levels at 8‐hourly intervals throughout their stay in ICU. A maximum of five assessments was obtained in the first 48 post‐operative hours from patients and their nurses. Pain intensity and pain distress were measured using separate 10‐point numerical rating scales (NRS). Patients' worst pain intensity scores increased over time in ICU; the amount of opioids they received was small and decreased over time. Significant differences occurred between patients' and nurses' average pain intensity scores at each time point and, except for worst pain intensity measures at the first assessment, nurses consistently underestimated patients' pain. These results indicate that patients in ICU following CABG can experience considerable pain, which is not always relieved. The application of regular systematic pain assessment and improved communication, together with the administration of adequate pain relief are necessary if nurses are to manage patients' pain effectively.

A Quality Improvement Survey to Assess Pain Management in Cardiac Surgery Patients

“…Pain intensity was moderate to severe in most of the older studies [19]. This statement may be less true today, given the changes in practice have occurred over the last decade.…”

“…Few patients believed that it was normal to have pain after surgery and pain might help in recovery. Nurses usually underestimate patient's pain which ultimately leads to under treatment [19]. Training of patients and medical staff [24] is very much needed to remove these fears.…”

Introducing the Cardibra: A Randomised Pilot Study of a Purpose Designed Support Bra for Women Having Cardiac Surgery

“…The pain was then scored during six types of different, but routine, postoperative activities. The notion that postoperative pain should not only be measured at rest but during normal daily activities is well supported [14,15]. In this study the activities chosen were resting in the supine position, coughing in the supine position, sitting upright, sitting upright and coughing, standing, standing and coughing.…”

Patients' perceptions of pain management after cardiac surgery in an australian critical care unit

“…9,10 Specifically, studies describe the intensity of cardiac surgical pain as fluctuating mainly between moderate to severe. [11][12][13][14] More than 20,000 cardiac surgical procedures are performed in Australia every year. 15 Despite the frequency of cardiac surgery, these patients experience substantial pain during the critical postoperative period.…”