Acute pain after surgery continues to be undertreated – despite new standards.
According to a paper in The Lancet Series on Pain, up to 75% of surgical patients in the USA fail to receive adequate post-op pain relief.
In the paper, Christopher L Wu and Srinivasa Raja from John Hopkins University and School of Medicine, Baltimore, USA review the progress made in treatments for postoperative pain over the past decade and stress that despite advances in pain management, a high percentage of patients continue to experience moderate-to-severe pain after surgery.
Inadequate post-surgical pain management is not just limited to adults, with a study from the USA reporting as many as 86% of children experiencing significant pain on the first day home after undergoing routine tonsillectomy.
Recent research also shows that the development of chronic pain after surgery, known as persistent postsurgical pain [PPP], is a frequent outcome of surgery. As many as 30–50% of patients undergoing common operations such as mastectomy, thoracotomy, hernia repair, and coronary artery bypass have to cope with PPP.
They authors say: “Why there has been little progress in the treatment of acute postoperative pain is unclear, but the causes might be multifactoral.”
They list greater patient awareness, more surveys and audits, deficiencies in education pain management for health workers, poor adherence to guidelines and underuse of effective analgesic techniques as possible causes.
“Additional studies on predictors of postoperative pain and persistent postsurgical pain, efficacy of multimodal analgesic regimens, and growth of promising new technologies might lead to substantial gains in the treatment of acute postoperative pain and potential reduction in the development of persistent pain states,” conclude the authors.