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PLoS One. 2019 May 1;14(5):e0215563. doi: 10.1371/journal.pone.0215563. eCollection 2019.

Quality of postoperative pain management in Ethiopia: A prospective longitudinal study.

Author information

1
Department of Anesthesiology, Institute of Health, Faculty of Medicine, Jimma University, Jimma, Ethiopia.
2
CIHLMU Center for International Health, Medical Center of the University of Munich (LMU), Munich, Germany.
3
Multidisciplinary Pain Center, Department of Anesthesiology, University Hospital, Ludwig Maximilians University (LMU), Munich, Germany.
4
Department of General, Visceral und Transplantation Surgery, Medical Center of the University of Munich (LMU), Munich, Germany.
5
Department of Psychiatry, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
6
Department of Pediatrics and Child Health, Institute Of Health, Faculty of Medicine, Jimma University, Jimma, Ethiopia.

Abstract

BACKGROUND:

The annual number of surgical operations performed is increasing throughout the world. With this rise in the number of surgeries performed, so too, the challenge of effectively managing postoperative pain. In Africa, there are scanty data available that make use of multi-center data to characterize the quality of postoperative pain management. In this study using a longitudinal data, we have attempted to characterize the quality of postoperative pain management; among patients scheduled for major elective orthopedic, gynecologic and general surgery.

METHODS:

This prospective longitudinal study evaluated the quality of postoperative pain management in patients undergoing elective general, gynecologic, and orthopedic surgery. We quantified the prevalence of moderate to severe postoperative pain with the International Pain Outcome Questionnaire and the corresponding adequacy of treatment with the pain management index. At four time points after surgery, we estimated pain severity, its physical and emotional interference, and patient satisfaction.

RESULTS:

Moderate to severe postoperative pain was present in 88.2% of patients, and pain was inadequately treated in 58.4% of these patients. Chronic pain (β = 0.346, 95% CI: 0.212, 0.480) predicted patients' worst pain intensity. Gender was not associated with the worst pain intensity or percentage of time spent in severe pain. Patient's pain intensity did not predicted the level of satisfaction.

CONCLUSIONS:

The prevalence of moderate to severe postoperative pain and its functional interference is high in Ethiopian patients. The treatment provided to patients is inadequate and not in line with international recommendations and standards.

Conflict of interest statement

The authors have declared that no competing interests exist.

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