A 5-year prospective review of postoperative pain management in Ahmadu Bello University Teaching Hospital Zaria: Challenges and way forward

Background: Perception of postoperative pain varies. It depends on the type of surgery and the individual involved, which is influenced by race. Postoperative pain, in general, is inadequately managed in developing countries. This study prospectively reviewed the challenges of postoperative pain management in our center, the incidences and other options available for effective postoperative pain management. Methods: Following hospital ethics approval and informed consent, a 5-year prospective review of postoperative pain management was carried out on 3623 patients operated in Ahmadu Bello University Teaching Hospital under subspecialty of general, maxillofacial, orthopedic, and obstetrics and gynecology surgeries, from January 2013 to December 2017. Following the enlightenment of patients about numeric pain score scale, pain scores of the patients that met the inclusion criteria were determined 24 h postoperatively through a predesigned questionnaire. Numeric pain scale was used to ascertain pain intensity and the level of satisfaction following postoperative pain management. The surgeons' and the anesthetic review, as well as the anesthetic chart of the 3623 patients managed, were studied. The incidence of the degree of pain scores was calculated for the different patient's populations. Techniques of anesthesia were also computed. Data were analyzed using Chi-square statistical package. Results: High rate of severe pain incidences was observed. Out of the overall 3623 patients managed within the study period, 42.1% (1525) of the patients reported severe pain. About 43.8% (1587) of patients had moderate pain and only 14.1% (511) of the patients recorded mild pain. Most of the patients [56.1% (2033)] had general anesthesia, while 41.5% (1503) had regional anesthesia. Around 2.4% (87) of the patients had both general and regional anesthesia. Conclusion: Postoperative pain is inadequately managed. There is need for the policymakers to provide intensive intervention on postoperative pain management by considering adequate supply of strong opioids regularly. More so, knowledge of the anesthetists and physicians involved in postoperative pain management need to be improved and updated, especially on the techniques for managing postoperative pain.