Postoperative pain assessment based on numeric ratings is not the same for patients and professionals: A cross-sectional study

Dijk, Jacqueline F.M. van; Wijck, Albert J. M. van; Kappen, Teus H.; Peelen, Linda M.; Kalkman, Cor J.; Schuurmans, Marieke J.

doi:10.1016/j.ijnurstu.2011.07.009

Cited by 98 publications

(68 citation statements)

References 28 publications

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“…Multiple studies from diverse settings have consistently found that patient-reported scores do not accurately predict the desire for analgesic therapy. [5][6][7][8][9][10][11] In their article, Chang et al 1 corroborate these previous findings, with 51% of their subjects declining further analgesics at least once despite reporting a pain score of 5 or greater and 21% similarly declining analgesics despite a score of 7 or greater. The authors observe that "the large variability.reinforces the necessity of asking patients if they want additional medication rather than basing treatment decisions on patients' reported level of pain."…”

Section: What Are Pain Scores Measuring?mentioning

confidence: 67%

“…5,19 Some patients decline pain medications because of concerns about drug-associated adverse effects (eg, nausea, pruritus, constipation, not feeling in control), allergy, potential opioid addiction (even if unfounded), or the need to drive themselves home. [5][6][7]19 Still others want analgesia, but would prefer to leave the ED quickly with their prescription in hand and begin treatment in the comfort of their own home. Others reporting pain are established drug seekers for whom opioids should be appropriately refused, or have absolute or relative contraindications to opioid administration such as hypotension, respiratory impairment, allergy, or altered mentation.…”

Section: Do All Patients In Pain Want Analgesics?mentioning

confidence: 99%

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The Numeric Scoring of Pain: This Practice Rates a Zero Out of Ten

Green

Krauss

2016

Annals of Emergency Medicine

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Section: What Are Pain Scores Measuring?mentioning

confidence: 67%

Section: Do All Patients In Pain Want Analgesics?mentioning

confidence: 99%

The Numeric Scoring of Pain: This Practice Rates a Zero Out of Ten

Green

Krauss

2016

Annals of Emergency Medicine

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“…It has repeatedly been demonstrated that medical staff commonly misjudge the pain intensity that patients are experiencing. 12,13 Therefore, the administration of analgesics should be adjusted according to the individual patient's reported pain scores and desire for additional medication. In the present study, we were able to demonstrate that patients undergoing minor surgeries typically received no or low doses of opioids.…”

Section: Discussionmentioning

confidence: 99%

Pain Intensity on the First Day after Surgery

et al. 2013

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Background: Severe pain after surgery remains a major problem, occurring in 20-40% of patients. Despite numerous published studies, the degree of pain following many types of surgery in everyday clinical practice is unknown. To improve postoperative pain therapy and develop procedurespecific, optimized pain-treatment protocols, types of surgery that may result in severe postoperative pain in everyday practice must first be identified. Methods: This study considered 115,775 patients from 578 surgical wards in 105 German hospitals. A total of 70,764 patients met the inclusion criteria. On the first postoperative day, patients were asked to rate their worst pain intensity since surgery (numeric rating scale, 0-10). All surgical procedures were assigned to 529 well-defined groups. When a group contained fewer than 20 patients, the data were excluded from analysis. Finally, 50,523 patients from 179 surgical groups were compared. Results: The 40 procedures with the highest pain scores (median numeric rating scale, 6-7) included 22 orthopedic/trauma procedures on the extremities. Patients reported high pain scores after many "minor" surgical procedures, including appendectomy, cholecystectomy, hemorrhoidectomy, and tonsillectomy, which ranked among the 25 procedures with highest pain intensities. A number of "major"

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“…These numbers are imposingly demonstrating on one hand how painful HNC surgery is and on the other hand might reflect that the medical staff is misjudging the pain intensity of HNC patients like is known in general for postoperative pain [13]. So far only some quality of life studies have called indirectly attention to the prevalence of relevant postoperative pain after HNC surgery as quality of life assessments typically include pain as one dimension.…”

Section: Discussionmentioning

confidence: 99%

Pain on the first postoperative day after head and neck cancer surgery

Inhestern

Schuerer

Illge

et al. 2014

Eur Arch Otorhinolaryngol

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Postoperative pain within the first 24 h after head and neck cancer (HNC) surgery was assessed. Factors influencing postoperative pain were identified. In a prospective cohort single center study 145 HNC patients rated their pain on the first postoperative day using questionnaires of the German-wide project Quality Improvement in Postoperative Pain Treatment (QUIPS) including numeric rating scales (NRS, 0-10) for the determination of patient's pain on ambulation, his maximal and minimal pain. QUIPS allowed a standardized assessment of patients' characteristics and pain-related parameters. The influence of these parameters on the patients' postoperative pain was estimated by univariate and multivariate statistical analysis. One-third had already pain prior to the surgical intervention. Overall, the mean pain on ambulation, maximal pain and minimal pain were 2.55 ± 2.36, 3.18 ± 2.86, and 1.38 ± 2.86 (NRS), respectively. 53 % of the patients had maximal pain scores >3. Multivariate analysis revealed independent predictors for more postoperative pain on ambulation: intensity of chronic preoperative pain, usage of non-opioids on ward, and existence of pain documentation on ward. Intensity of chronic preoperative pain and usage of non-opioids on ward were independent risk factors for more maximal pain. Intensity of chronic preoperative pain was independently associated to more minimal pain. Concerning pain management side effects, the risk for drowsiness increased with longer time of surgery. Postoperative pain after HNC surgery is highly variable and seems often to be unnecessarily high. Many patients seem to receive less analgesia than needed or ineffective analgesic drug regimes.

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Postoperative pain assessment based on numeric ratings is not the same for patients and professionals: A cross-sectional study

Cited by 98 publications

References 28 publications

The Numeric Scoring of Pain: This Practice Rates a Zero Out of Ten

The Numeric Scoring of Pain: This Practice Rates a Zero Out of Ten

Pain Intensity on the First Day after Surgery

Pain on the first postoperative day after head and neck cancer surgery

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