Evaluation of acute pain management in ambulatory herniorrhaphy during free surgical outreach in Akwa Ibom State, South-South Nigeria.
1 Department of Anaesthesia, University of Uyo Teaching Hospital, Uyo, Akwa Ibom State.
2 Department of Surgery, University of Uyo Teaching Hospital, Uyo, Akwa Ibom State.
3 Department of Orthopaedics and Traumatology, University of Uyo Teaching Hospital, Uyo, Akwa Ibom State.
4 Department of Physiology, Faculty of Basic Medical Sciences, University of Uyo, Uyo, Nigeria.
Research Article
GSC Biological and Pharmaceutical Sciences, 2020, 11(02), 130-138.
Article DOI: 10.30574/gscbps.2020.11.2.0122
Publication history:
Received on 01 May 2020; revised on 09 May 2020; accepted on 11 May 2020
Abstract:
Surgical outreach Program is a platform where a large number of elective surgical patients are treated within a short time, usually on ambulatory basis by a volunteer surgical team at no cost to the patients. Inguinal hernia repair is usually the commonest procedure performed. However, acute postoperative pain associated with it is not often investigated in our environment.
All adult patients with uncomplicated inguinal hernia who consented to the study were recruited. The choice of anaesthesia, surgical technique and postoperative analgesics used were as per the discretion of the individual surgical team members. Postoperatively, the patients were interviewed through a telephone call using a structured questionnaire for three consecutive days after the surgery. Data obtained were analyzed using SPSS version 16.
A total of 43 patients, 34 males, 9 females were recruited. The mean age was 42.86 years. Local anaesthesia (LA) only was the commonest anaesthetic technique (42.2%), followed by LA + sedation (30.2%). Unimodal analgesic regimen as against multimodal regimen was used in 46.5% and 53.5% patients respectively. The incidence of moderate to severe pain was highest on the first day after surgery (72.5%), and it was statistically significant compared with No pain/mild pain (27.5%), p value = 0.002. More patients treated with unimodal compared with multimodal analgesic regimen had moderate to severe pain (56.7% vs 43.3%).
Surgical outreach program is useful in reducing surgical disease burden. However, the incidence of acute moderate to severe postoperative pain is high (72.5%). Therefore, a standard protocol that is effectively communicated to all members of the surgical team must be developed in order to reduce this morbidity.
Keywords:
Acute postoperative pain; Ambulatory herniorrhaphy; Free surgical outreach
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Copyright © 2020 Author(s) retain the copyright of this article. This article is published under the terms of the Creative Commons Attribution Liscense 4.0
