Improved analgesia after the realisation of a pain management programme in ICU patients after cardiac surgery

Gulik, Laura van; Ahlers, Sabine; Brkić, Zina; Belitser, Svetlana V.; Boven, Wim Jan van; Dongen, Eric P. van; Knibbe, Catherijne; Bruins, Peter

doi:10.1097/eja.0b013e32833d91c3

Cited by 35 publications

(39 citation statements)

References 19 publications

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“…While the data sets of pain levels in the first postoperative week of both the ICU and ward were available as a result of a previous study [11], the telephone interviews were performed specifically for this study. Patients were asked to describe their symptoms for the 2 preceding weeks retrospectively.…”

Section: Discussionmentioning

confidence: 99%

“…Pain scores were recorded both in the ICU and on the ward from day 0 until day 7 after surgery. Following local clinical practice, pain levels were scored at least 3 times a day while in the ICU [11], and at least once a day while on the ward. Upon arrival in the ICU, patients received a continuous intravenous infusion of morphine (2 mg h À1 ) in combination with acetaminophen (1 g orally or rectally 4 times a day), according to standard protocol [11].…”

Section: Peri-and Postoperative Procedures and Pain Scoresmentioning

confidence: 99%

“…Following local clinical practice, pain levels were scored at least 3 times a day while in the ICU [11], and at least once a day while on the ward. Upon arrival in the ICU, patients received a continuous intravenous infusion of morphine (2 mg h À1 ) in combination with acetaminophen (1 g orally or rectally 4 times a day), according to standard protocol [11]. Additional administration and tapering of morphine was executed by the attending intensivists and nurses based upon the reported pain scores.…”

Section: Peri-and Postoperative Procedures and Pain Scoresmentioning

confidence: 99%

See 2 more Smart Citations

Risk factors for chronic thoracic pain after cardiac surgery via sternotomy

Gulik

Janssen

Ahlers

et al. 2011

European Journal of Cardio-Thoracic Surgery

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101

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We have identified a number of factors correlated with persistent thoracic pain following cardiac surgery with sternotomy. Awareness of these predictors may be useful for further research concerning both the prevention and treatment of chronic thoracic pain, thereby potentially ameliorating the postoperative quality of life of a significant proportion of patients. Meanwhile, chronic thoracic pain should be discussed preoperatively with patients at risk so that they are truly informed about possible consequences of the surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Peri-and Postoperative Procedures and Pain Scoresmentioning

confidence: 99%

Section: Peri-and Postoperative Procedures and Pain Scoresmentioning

confidence: 99%

See 1 more Smart Citation

Risk factors for chronic thoracic pain after cardiac surgery via sternotomy

Gulik

Janssen

Ahlers

et al. 2011

European Journal of Cardio-Thoracic Surgery

Self Cite

101

View full text Add to dashboard Cite

show abstract

“…Pain management program with specific guidelines also have a role in managing postoperative pain effectively. Jocelyn et al in their practice guideline used paracetamol and In-domethacin (NSAID) on regular basis along with intermittent doses of intravenous morphine and found that it was 95% effective in relieving pain [26].…”

Section: Discussionmentioning

confidence: 99%

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

Hamid¹,

Gangwani²,

Akhtar³

2015

OJAnes

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Objective: To evaluate the quality of pain management in cardiac ICU patients by using a questionnaire. Methodology: All post cardiac surgery patients between 18 and 75 years old were included in this survey. Chronic pain patients, paediatric patients, emergency surgeries were excluded. A predesigned proforma was prepared according to American Pain Society recommendations and distributed among Cardiac ICU patients after 24 hours of extubation. This proforma was explained to the patients and collected later. The questionnaire was related to pain severity, aggravating and relieving factors, side effects of analgesics, affective experience and satisfaction with pain management. Results: Total 308 patients participated in one year period. 243 (78.9%) were male and 65 (21.1%) were female. Multimodal analgesia was used in most of the patients. Severity of pain was described as mild 70% and moderate 28.6%. Most of the patients complained of sharp pain 100 (37.5%), mainly at the site of incision 129 (41.9%). The main aggravating factor associated with increased pain was deep breathing 118 (39.8%) while pain was minimized by taking pain medications 40.6%. A significant association was found between preoperative counseling about pain options and satisfaction. 96.8% reported satisfaction with pain management. Conclusion: Although overall pain control was reported as adequate and patients were highly satisfied, there were areas which need further improvement. These include strategies to provide preoperative information about postoperative pain management and better training of medical staff to assess and manage pain. Additionally, the concerns and fears of patients about pain treatment need to be addressed.

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“…Between 63% and 77% of patients report experiencing pain while in the ICU. 1 An observational study in 128 Italian ICUs of 661 postoperative patients found that 36.3% of patients did not receive any analgesia in the first 48 hours of their ICU stay. 2 "Pain control" was the reason for the opioid administration in only 54.5% of instances in which an opioid was given.…”

Section: Prevalence Of Pain In the Intensive Care Unitmentioning

confidence: 99%