Quality of pain treatment after caesarean section: Results of a multicentre cohort study

Marcus, Hanke; Gerbershagen, Hans J.; Peelen, Linda M.; Aduckathil, Sanjay; Kappen, Teus H.; Kalkman, Cor J.; Meißner, Winfried; Stamer, Ulrike

doi:10.1002/ejp.619

Cited by 53 publications

(61 citation statements)

References 53 publications

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“…2 When compared with 179 other operative procedures, cesarean delivery pain was ranked number 9 (with a number 1 ranking being the worst) with the mean worst pain intensity during the first 24 hours postoperatively as 6.2 (out of 10) on a numeric rating scale (NRS; 0-10). 3 Inadequately controlled pain after cesarean delivery may negatively affect breastfeeding/infant care and is associated with an increase in postpartum depression. 2,4 Nonsteroidal anti-inflammatory agents (NSAIDs) are potent analgesics that are effective in the treatment of postoperative pain.…”

Section: Discussionmentioning

confidence: 99%

The Analgesic Efficacy of Nonsteroidal Anti-inflammatory Agents (NSAIDs) in Patients Undergoing Cesarean Deliveries

Zeng

Nami

et al. 2016

Regional Anesthesia and Pain Medicine

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The perioperative use of NSAIDs in cesarean delivery patients will result in a significantly lower pain scores, less opioid consumption, and less drowsiness/sedation but no difference in nausea or vomiting compared to those who did not receive NSAIDs. Further research should address the optimal NSAID regimen and examine the effect of improved analgesia on patient-centered outcomes such as patient satisfaction and quality of breastfeeding.

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Section: Discussionmentioning

confidence: 99%

The Analgesic Efficacy of Nonsteroidal Anti-inflammatory Agents (NSAIDs) in Patients Undergoing Cesarean Deliveries

Zeng

Nami

et al. 2016

Regional Anesthesia and Pain Medicine

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“…But also using QUIPS, similar positive effects have been described in improving pain management after septorhinoplasty21 or comparing pain after caesarean section18.…”

Section: Discussionmentioning

confidence: 79%

“…The data were collected for the project ‘Quality Improvement in Postoperative Pain Treatment’ (QUIPS), a benchmark initiative for comparing pain outcome parameters among participating hospitals. This project has been supported by the German Society of Anesthesiologists and the German Society of Surgeons1618. Patients older than 18 years who had received primary TKA and were able to communicate were included.…”

Section: Methodsmentioning

confidence: 99%

Implementing a benchmarking and feedback concept decreases postoperative pain after total knee arthroplasty: A prospective study including 256 patients

Benditz

Drescher

Greimel

et al. 2016

Sci Rep

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Perioperative pain reduction, particularly during the first two days, is highly important for patients after total knee arthroplasty (TKA). Problems are not only caused by medical issues but by organization and hospital structure. The present study shows how the quality of pain management can be increased by implementing a standardized pain concept and simple, consistent benchmarking. All patients included into the study had undergone total knee arthroplasty. Outcome parameters were analyzed by means of a questionnaire on the first postoperative day. A multidisciplinary team implemented a regular procedure of data analyzes and external benchmarking by participating in a nationwide quality improvement project. At the beginning of the study, our hospital ranked 16th in terms of activity-related pain and 9th in patient satisfaction among 47 anonymized hospitals participating in the benchmarking project. At the end of the study, we had improved to 1st activity-related pain and to 2nd in patient satisfaction. Although benchmarking started and finished with the same standardized pain management concept, results were initially pure. Beside pharmacological treatment, interdisciplinary teamwork and benchmarking with direct feedback mechanisms are also very important for decreasing postoperative pain and for increasing patient satisfaction after TKA.

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“…However, based on the QUIPS project, similar positive effects have been described in improving pain management after septorhinoplasty20 or comparing pain after cesarean section 15…”

Section: Discussionmentioning

confidence: 86%

“…This project has been supported by the German Society of Anesthesiologists and the German Society of Surgeons 14,15. The project was approved by the ethics committee and the data security board of the Jena University Hospital, Jena, Germany, as well as by the ethics committee of the University of Regensburg.…”

Section: Methodsmentioning

confidence: 99%

Can consistent benchmarking within a standardized pain management concept decrease postoperative pain after total hip arthroplasty? A prospective cohort study including 367 patients

Benditz

Greimel

Auer

et al. 2016

JPR

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BackgroundThe number of total hip replacement surgeries has steadily increased over recent years. Reduction in postoperative pain increases patient satisfaction and enables better mobilization. Thus, pain management needs to be continuously improved. Problems are often caused not only by medical issues but also by organization and hospital structure. The present study shows how the quality of pain management can be increased by implementing a standardized pain concept and simple, consistent, benchmarking.MethodsAll patients included in the study had undergone total hip arthroplasty (THA). Outcome parameters were analyzed 24 hours after surgery by means of the questionnaires from the German-wide project “Quality Improvement in Postoperative Pain Management” (QUIPS). A pain nurse interviewed patients and continuously assessed outcome quality parameters. A multidisciplinary team of anesthetists, orthopedic surgeons, and nurses implemented a regular procedure of data analysis and internal benchmarking. The health care team was informed of any results, and suggested improvements. Every staff member involved in pain management participated in educational lessons, and a special pain nurse was trained in each ward.ResultsFrom 2014 to 2015, 367 patients were included. The mean maximal pain score 24 hours after surgery was 4.0 (±3.0) on an 11-point numeric rating scale, and patient satisfaction was 9.0 (±1.2). Over time, the maximum pain score decreased (mean 3.0, ±2.0), whereas patient satisfaction significantly increased (mean 9.8, ±0.4; p<0.05). Among 49 anonymized hospitals, our clinic stayed on first rank in terms of lowest maximum pain and patient satisfaction over the period.ConclusionResults were already acceptable at the beginning of benchmarking a standardized pain management concept. But regular benchmarking, implementation of feedback mechanisms, and staff education made the pain management concept even more successful. Multidisciplinary teamwork and flexibility in adapting processes seem to be highly important for successful pain management.

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Quality of pain treatment after caesarean section: Results of a multicentre cohort study

Cited by 53 publications

References 53 publications

The Analgesic Efficacy of Nonsteroidal Anti-inflammatory Agents (NSAIDs) in Patients Undergoing Cesarean Deliveries

The Analgesic Efficacy of Nonsteroidal Anti-inflammatory Agents (NSAIDs) in Patients Undergoing Cesarean Deliveries

Implementing a benchmarking and feedback concept decreases postoperative pain after total knee arthroplasty: A prospective study including 256 patients

Can consistent benchmarking within a standardized pain management concept decrease postoperative pain after total hip arthroplasty? A prospective cohort study including 367 patients

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