Comparative analysis of visual analogue scale and the new scale of efficacy and safety of postoperative analgesia for orediction of pain during the early postoperative period


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Abstract

Modern postoperative analgesia - is an individual selection of optimal doses of analgesics in order to obtain high efficiency of analgesia with minimal side effects. The quality and safety of postoperative pain is largely dependent on the severity of pain immediately after the operation. The aim of the study was to compare the efficacy of visual analogue scale (VAS) and the new scale of efficiency and safety (ESS) of postoperative analgesia in predicting of the severity of pain and postoperative complications. The study was conducted in 209 patients (mean age (66-77) years), in which a major surgery on the abdominal organs were routinely performed. Patients were randomized into two groups, depending on the method of evaluating of the quality of analgesia: in group 1 is controlled via ESS (n = 102), the 2nd group - by VAS (n = 105). Postoperative complications were recorded: nausea and vomiting, respiratory failure (need for noninvasive or invasive ventilation), delirium, cardiac arrhythmias, ileus. ESS and VAS demonstrated good prediction of the effectiveness of pain relief (AUROC 0,973, [0,913-0,996] and 0.976 [0,913-0,997], respectively). ESS showed a good prediction of the complicated postoperative period (AUROC = 0,924, [0,856-0,967]), as opposed to the VAS (AUROC = 0,649, [0,548-0,741]). Baseline ESS and VAS score equally effective in predicting the intensity of pain in the early postoperative period. ESS advantage, compared to VAS, is the ability to predict complicated postoperative period and postoperative complications. ESS score for more than 17 is a risk factor for postoperative complications associated with inadequate analgesia.

About the authors

Igor Borisovich Zabolotskikh

Kuban State Medical University

Email: pobeda_zib@mail.ru
MD, PhD, DSc, professor, head of department of anesthesiology, reanimatology and transfusiology 350063, Krasnodar, Russian Federation

V. M Durleshter

Kuban State Medical University

350063, Krasnodar, Russian Federation

T. S Musaeva

Kuban State Medical University

350063, Krasnodar, Russian Federation

N. V Trembach

Kuban State Medical University

350063, Krasnodar, Russian Federation

V. A Makarenko

Kuban State Medical University

350063, Krasnodar, Russian Federation

E. Skraastad

Kongsberg hospital

Kongsberg, Norway

L. Dybvik

Oslo university hospital

Oslo, Norway

A. Eltaeva

«Astana Medical University»

Astana, Kazakhstan

A. K Konkaev

«Astana Medical University»

Astana, Kazakhstan

V. N Kuklin

Ahus university hospital

Oslo, Norway

References

  1. Карпов И.А., Овечкин А.М. Послеоперационное обезболивание в абдоминальной хирургии: боль в абдоминальной хирургии, эпидемиология и клиническое значение. Новости анестезиологии и реаниматологии 2004; 4: 47-60.
  2. Овечкин А.М., Романова Т.Л. Послеоперационное обезболивание: оптимизация подходов с точки зрения доказательной медицины. Русский медицинский журнал. 2006; 12 (264): 865-871.
  3. Морган Д. Э-мл., Михаил М. С. Клиническая анестезиология: книга 1-я / Изд. 2-е, испр. пер. с англ. M.- СПб.: Издательство БИНОМ-Невский Диалект, 2001.
  4. Овечкин А.М., Свиридов С.В. Послеоперационная боль и обезболивание: современное состояние проблемы. Регионарная анестезия и лечение острой боли. 2006; 1(0): 1-15.
  5. Liu S.S., Wu C.L. Effect of postoperative analgesia on major postoperative complications: a systematic update of the evidence. Anesth Analg. 2007; 104(3): 689-702.
  6. Sommer M. et al. The prevalence of postoperative pain in a sample of 1490 surgical inpatients. Eur. J. Anaesthesiol. 2008; 25: 267-274.
  7. Williamson A., Hoggart B. Pain: a review of three commonly used pain rating scales. J. Clin. Nurs. 2005; 14(7): 798-804.
  8. Breivik E.K., Björnsson G.A., Skovlund E. A comparison of pain rating scales by sampling from clinical trial data. Clin. J Pain. 2000; 16(1): 22-28.
  9. Stratford P. W., Spadoni G. The reliability, consistency, and clinical application of a numeric pain rating scale. Physiotherapy Canada. 2000; 53(2): 88-91.
  10. Bergh I., Sjöström B., Odén A., Steen B. An application of pain rating scales in geriatric patients. Aging. 2000; 12 (5): 380-387.
  11. Williamson A., Hoggart B. Pain: a review of three commonly used pain rating scales. Journal of Clinical Nursing. 2005; 14 (7): 798-804.
  12. Breivik H., Borchgrevink P.C., Allen S.M. et al. Assessment of pain. British Journal of Anaesthesia. 2008; 101 (1): 17-24.
  13. Maier C., Nestler N., Richter H. et al. The quality of pain management in German hospitals. Dtsch. Arztebl. Int. 2010; 107: 607-614.
  14. Fredheim O.M.S. et al. Postoperativ smerte hos pasienter innlagt i norske sykehus. Tidsskr. Nor. Legeforen. 2011; 131: 1763-1767.
  15. Apfelbaum J.L., Chen C., Mehta S.S., Gan T.J. Postoperative pain experience: results from a national survey suggest postoperative pain continues to be undermanaged. Anesth Analg. 2003; 97 (2): 534-540.
  16. Dolin S.J., Cashman J.N., Bland J.M. Effectiveness of acute postoperative pain management: I. Evidence from published data. Br. J. Anaesth. 2002; 89: 409-423.
  17. Dolin S.J., Cashman J.N. Tolerability of acute postoperative pain management: nausea, vomiting, sedation, pruritus, and urinary retention. Evidence from published data. Br. J. Anaesth. 2005; 95 (5): 584-591.
  18. Skraastad J.E., Bjertnæs L.J., Ræder J., Kuklin V. Kongsberg Satisfaction Score - et verktøy for bedre postoperativ overvåkning og behandling. Tidsskrift for Norsk anestesiologisk forening. 2013; 26-4: 36-41.

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