Outcome following introduction of a procedure specific pain management programme for caesarean section

Abstract

Based on the results of a prospective audit conducted in 2014 among 310 post caesarean section patients (Group A) at Tuen Mun Hospital, Hong Kong, a procedure specific postoperative pain management programme was implemented. To complete the audit cycle, a second prospective audit was conducted in 2015 among 332 patients (Group B). The proportion of patients with severe pain (VAS>=7/10) reduced significantly from 55.5% (Group A) to 23.0% (Group B) (p<0.001). In Group A, 8% of patients were dissatisfied with the pain relief and this figure dropped significantly to 0.7% after the introduction of the pain management programme (p<0.001). Significantly larger number of patients received preoperative information. (19.5% in Group A vs. 64.7% in Group B, p<0.001). Percentage of patients having pain assessment and reassessment by ward nurses also significantly increased. (p<0.001). In Group B, we managed to enforce a more consistent implementation of evidence-based best practice in our Obstetric unit and decrease the variability of anaesthetic practice. Our findings show that a postoperative pain management programme designed in an evidence-based procedure specific manner can reduce postoperative pain and improve patient satisfaction.