Patients’ Expectations of Postoperative Pain vs Actual Pain

doctors performing surgery
doctors performing surgery
Patients receiving regional anesthesia are unable to accurately predict pain outcomes after surgery.
The following article features coverage from Anesthesiology 2017 in Boston, Massachusetts. Click here to read more of Clinical Pain Advisor‘s conference coverage.

Patients receiving regional anesthesia are unable to predict pain outcomes accurately after surgery, according to survey results presented at Anesthesiology 2017, held October 21-25, in Boston, Massachusetts.

“With advancements in regional anesthesia, great strides have been made in preventing postoperative pain,” the study’s lead investigator, Amir C. Dayan, MD, an anesthesiology specialist at the Thomas Jefferson University Hospital in Philadelphia, Pennsylvania, told Clinical Pain Advisor. His team sought to determine patients’ expectations about pain level following surgery, especially among those receiving regional anesthesia.

The investigators recruited 223 patients who were undergoing neurosurgical, orthopedic, or general surgery procedures. A presurgery questionnaire was administered to examine patients’ expectations about postoperative pain outcomes. Using a 10-point numeric rating scale to evaluate pain levels, researchers obtained patient-reported pain outcomes approximately 1 hour after surgery and on postoperative day 1.

Average pain expectation rating was 4.66±0.220 vs 2.56±0.224 approximately 1 hour after surgery (P <.001). The average pain expectation vs actual pain rating on postoperative day 1 was 5.45±0.174 vs 4.30±0.205 (P <.001).

For patients receiving regional anesthesia, average expected vs actual postoperative pain ratings were 4.63±0.358 vs 0.92±0.231 (P <.001). In addition, expected vs actual pain ratings on the first postoperative day in these patients were 5.47±0.267 vs 3.45±0.329 (P <.001).

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Based on the findings, the investigators concluded that many healthcare providers are not educating patients adequately about expected pain following surgery, particularly patients receiving regional anesthesia.

“Given the clear benefit of patient education and anxiety alleviation on postoperative pain, providers must find ways to effectively manage patient expectations to help improve outcomes,” concluded the investigators.

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Dayan AC, Qiu J, John EB, Baratta JL, Viscusi ER. Inaccuracies of patients’ postoperative pain predictions: setting reasonable expectations. Presented at: Anesthesiology 2017; October 21-25, 2017; Boston, MA. Abstract A1164.