| Summary: | 碩士 === 嘉南藥理科技大學 === 醫療資訊管理研究所 === 97 === Background. Postoperative pain is one of the most significant psychosomatic stresses of the patients before and after undertaking surgical intervention. Therefore, management of postoperative pain has been an important clinical issue in the post anesthesia care units (PACU). Among the available pain medicine, opioids are the most commonly prescribed analgesic for postoperative pain control. The present study aimed to identify the coexisting factors that affected the requirement of opioids in patients receiving gynecological surgery.
Methods. All the patients receiving gynecological surgery were recruited after admitted to the PACU. Patient demographic data, type of operation, predicted and patient’s self-report pain scales, and the total amount of pain medicine administered throughout the course were recorded. A pain scale was utilized to rate the pain intensity on the scale of 0 (no pain) to 10 (the worst pain imaginable). The relationships between opioid demand and these parameters were determined by multivariate analysis.
Results. Since opioid was prescribed according to the pain scale, the self-report pain scale was highly correlated with the dose of opioid administered. Numbers of drainage tubes indwelled were also significant independent predictors for postoperative requirement of opioids (interpretation variation of 68.8%). Using the standard receiver operating characteristic (ROC) curve, pain scale of 3 was determined as the threshold value for initiating pain management with a predicted probability of 47.6%.
Conclusion. Our results provide fundamental rationale for prescribing opioids in the management of postoperative pain following gynecological surgery. Application of optimal pain medicine at the appropriate time point may improve quality of postoperative care and patient contentment in the PACU.
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