Waking Up in Pain: a prospective unselected cohort study of pain in 3702 patients immediately after surgery in the Danish Realm

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

DOI

  • Anders Mølgaard Rasmussen, University of Copenhagen, University of Southern Denmark
  • ,
  • Mette Helene Toft, Herlev Hospital, Oncology, Herlev
  • ,
  • Hussein Nasser Awada, University of Copenhagen
  • ,
  • Jesper Dirks, University of Copenhagen
  • ,
  • Birgitte Brandsborg
  • Line Kirkegaard Rasmussen
  • ,
  • Ellen Kirkegaard
  • ,
  • Dorthe Hasfeldt-Hansen, University of Southern Denmark
  • ,
  • Thomas Egemose Larsen, University of Southern Denmark
  • ,
  • Georgios Charalampidis, University of Southern Denmark
  • ,
  • Emilie Louise Schjøtt Mørk, Herlev Hospital, Oncology, Herlev
  • ,
  • Chirstine Linaa Rosager, Herlev Hospital, Oncology, Herlev
  • ,
  • Idress Ahmad Salam, Aalborg University
  • ,
  • Bodil Steen Rasmussen, Aalborg University
  • ,
  • Marlene Jørgensen, Aalborg University
  • ,
  • Martin Skjønnemand, Pediatric Department, Gentofte University Hospital, Gentofte
  • ,
  • Caterina Amanti Lund, Hvidovre Hospital, Hvidovre
  • ,
  • Save Schroder, Esbjerg Central Hospital
  • ,
  • Johan Kløvgaard Sørensen
  • Christoffer Sølling
  • Kristian Kraft Hansen, Aarhus University
  • ,
  • Christina Kirkegaard Rasmussen, Department of Pediatrics, Kolding Hospital, Kolding, Denmark
  • ,
  • Nick Phaff Steen, Vejle Hospital
  • ,
  • Anne Staal Nielsen, Vejle Hospital
  • ,
  • Anja Geisler, Department of Anesthesiology, Zealand University Hospital Koege, Koege, Denmark.
  • ,
  • Kasper Storm Køppen, Department of Anesthesiology, Zealand University Hospital Koege, Koege, Denmark.
  • ,
  • Maria Bolther Pælestik
  • Thorbjørn Grøfte
  • Christian Sylvest Meyhoff, Bispebjerg Hospital, Bispebjerg
  • ,
  • Charlotte Loumann Kroh, Bispebjerg Hospital, Bispebjerg
  • ,
  • Amalie Prien Christensen, Pediatric Department, Hilleroed Hospital, Hilleroed, Denmark
  • ,
  • Aleksander Fjeld Haugstvedt, Pediatric Department, Hilleroed Hospital, Hilleroed, Denmark
  • ,
  • Maria Aagaard Hansen, Aarhus University
  • ,
  • Christian Viggo Nielsen, Aarhus University
  • ,
  • Bitten Dybdal, University of Copenhagen
  • ,
  • Lars Falcon, Juliane Marie Centre, Rigshospitalet, Copenhagen, Denmark.
  • ,
  • Daniel Hägi-Pedersen, Slagelse Hospital Region Zealand, Slagelse
  • ,
  • Kristian Jauho, Slagelse Hospital Region Zealand, Slagelse
  • ,
  • Henrik Wolsted, Slagelse Hospital Region Zealand, Slagelse
  • ,
  • Christian Alves Kohler Pedersen, South Jutland Hospital Aabenraa Campus
  • ,
  • Trine Nyboe Sommer, South Jutland Hospital Aabenraa Campus
  • ,
  • Laurits Schou Kromberg, Holbaek Hospital, Holbaek, Denmark.
  • ,
  • Danja Lykke Kristensen, Uiversity of Copenhagen
  • ,
  • Camilla Kara Svensson, Department of Emergency Medicine, Nykobing F Hospital; Department of Hospital Administration, Nykobing F Hospital, Nykøbing Falster.
  • ,
  • Hans Fjeldsøe Nielsen, Department of Emergency Medicine, Nykobing F Hospital; Department of Hospital Administration, Nykobing F Hospital, Nykøbing Falster.
  • ,
  • Martin Kryspin Sørensen, University of Copenhagen
  • ,
  • Stig Jacobsen, University of Copenhagen
  • ,
  • Martin Sundskard, Zealand University Hospital
  • ,
  • Nicole Brahe, Glostrup Hospital, University of Copenhagen
  • ,
  • Karina Jakobsen, Pediatric Department, Naestved Hospital, Naestved
  • ,
  • Mette Skov Jensen, Pediatric Department, Naestved Hospital, Naestved
  • ,
  • Lillian Odder, Aalborg University Hospital Thisted
  • ,
  • Hansjörg Selter, Aalborg University Hospital Thisted
  • ,
  • Tróndur Høgnason Mohr, Landssjúkrahúsid Dronning Alexandrines Hospital
  • ,
  • Elin H Jensen, Landssjúkrahúsid Dronning Alexandrines Hospital
  • ,
  • Pernille Pia Jensen, Dronning Ingrids Hospital, Nuuk
  • ,
  • Christine Skjold, Bornholms Hospital
  • ,
  • Eske Kvanner Aasvang, University of Copenhagen

BACKGROUND: Acute and persistent pain after surgery is well described. However, no large-scale studies on immediate postoperative pain in the operating room (OR) exist, hindering potential areas of research to improve clinical outcomes. Thus, we aimed to describe the occurrence and severity of immediate postoperative pain in a large, unselected cohort.

METHODS: This was a prospective cohort study, encompassing all procedures in 31 public hospitals in the Danish Realm, during a 5-day period including the weekend. Data on procedures and anesthesia were collected and the main outcome was occurrence of moderate or severe pain in the OR. Secondary outcomes included pain, sedation and nausea in the OR or during the first 15 min in the postanesthesia care unit (PACU) including relevant risk factors. Descriptive and logistic regression statistics were used.

RESULTS: A total of 3675 procedures were included for analysis (87% inclusion rate). Moderate or severe pain occurred in 7.4% (95% CI 6.5% to 8.3%) of cases in the OR immediately after awakening, rising to 20.2% in the OR and/or PACU. Large intraprocedure and interprocedure variations occurred (0.0%-37.5%), and in 20% of cases with epidural-general anesthesia patients experienced moderate or severe pain. Independent risk factors were female sex, younger age, preoperative pain, daily opioid use and major surgical procedures.

CONCLUSION: Moderate or severe pain in the immediate postoperative phase occurred in 20% of all cases with procedure and anesthesiological technique variations, suggesting a need for identification of relevant procedure-specific risk factors and development of preventive treatments.

TRIAL REGISTRATION NUMBER: RoPR ID 43191.

Original languageEnglish
JournalRegional Anesthesia and Pain Medicine
Volume46
Issue11
Pages (from-to)948-953
Number of pages6
ISSN1098-7339
DOIs
Publication statusPublished - Nov 2021

Bibliographical note

© American Society of Regional Anesthesia & Pain Medicine 2021. No commercial re-use. See rights and permissions. Published by BMJ.

    Research areas

  • acute pain, pain, pain management, postoperative

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