An audit on postoperative pain in liver resection surgery following epidural catheter removal

Abstract

The primary aim of this audit was to assess mean pain scores and type of analgesia used in the 5 days following epidural catheter removal in liver resection patients. The second aim was to determine whether postepidural pain intensity was influenced by the duration of epidural analgesia. Methods: Medical notes of 82 consecutive patients who underwent liver resection between January 2008 and April 2009 were obtained. Data regarding duration of epidural analgesia, the rate and type of analgesic solution used, pain scores post epidural analgesia, and postepidural analgesia were analyzed retrospectively. Results: Epidural analgesia was used for 4 days (range 2-6). Pain scoring became less vigilant as the postoperative days progressed. Pain scores on day 1 post epidural catheter removal were significantly higher than those on day 2 (0.6±0.8 vs 0.3±0.4, t-test, p = 0.047). The 6 principal analgesics prescribed to patients after epidural removal were paracetamol (98%), diclofenac (58%), dihydrocodeine (52%), tramadol (38%), morphine (16%) and oramorph (10%). Most patients received two or three analgesics. There was no correlation between duration of epidural analgesia and pain score. Conclusions: Postoperative pain still occurs in liver resection patients following epidural analgesia, particularly on day one. Pain assessment was insufficient and different analgesic modalities were used. There needs to be clear plan regarding pain assessment and treatment. Pain intensity does not correlate with the duration of epidural analgesia used. © 2011 Nova Science Publishers, Inc.