Insights On Postoperative Pain Management: Drug Prescribing Patterns & Challenges

Postoperative pain management remains an integral part of patient care after surgery and it is very essential to effectively manage post-surgery pain in patients. Persistent pain and poor treatment outcomes can delay recovery, increase hospital stay, and affect patient satisfaction. For managing any intensity of pain, the focus should be on effective pain relief while minimizing unwanted or harmful effects of therapy.

To evaluate the drug prescribing patterns and challenges related to managing postoperative pain we conducted an in-app survey on the WhiteCoats app to determine the drug prescribing patterns and challenges that doctors face while managing postoperative pain in patients.

A total of 139 doctors responded to the survey which consisted of anesthesiologists (55.40%), general surgeon (23.02%), pediatric surgeon (7.91%), orthopaedic surgeon (3.60%), head and neck surgeon (2.16%), neurosurgeon (2.16%), cardiothoracic and vascular surgeon (1.44%), plastic surgeon (1.44%), surgical gastroenterologist (1.44%), and trauma care (1.44%).

43.17% of doctors stated that they prescribed either opioid analgesics, local anaesthetics, regional anaesthetics, NSAIDs, or centrally acting non-opioids for postoperative pain management. NSAIDs were prescribed by 31.65% of doctors, while 16.55% of doctors recommend opioid analgesics for managing postoperative pain.

Most doctors prefer the parenteral (60.43%) route of administration followed by the oral (18.71%) and epidural (15.11%) route.

The survey found that 79.86% of patients complained at some point in time about side effects or adverse effects after administering postoperative pain-relieving medications.

69.06% of doctors stated that either age, comorbidities, previous surgery, speedy recovery, addictions/abuse or decreasing side-effects and adverse events were the patient-related factors that influenced the choice of medication for postoperative pain management. Among these, age (10.07%) and comorbidities (8.63%) had a higher impact on the choice of drug prescribed.

Almost 71.22% of physicians agreed that either the type of surgery, onset of action, practice experience, hospital formulary or simplicity of treatment regimen were the clinical factors considered while prescribing drugs for managing postoperative pain. Among these factors, type of surgery (17.99%) was one of the highly considered clinical factors.

Our focus was to determine physicians’ perspectives on postoperative pain management and the factors that determine the selection of pain-relieving medications.

It was found that parenteral NSAIDs are still the preferred choice of a drug by a majority of doctors for a postoperative pain management protocol.

An adverse event due to medications can delay the patient’s recovery and affect the overall health. Managing postoperative pain may require an individualized treatment plan based on the various patient-related and clinical factors affecting the treatment outcome.

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