This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (174) Citing Articles via Google Scholar Google Scholar Articles by Apfelbaum, J. L. Articles by Gan, T. J. Search for Related Content PubMed PubMed Citation Articles by Apfelbaum, J. L. Articles by Gan, T. J. Related Collections Economics and Health Care Research Surgery Pain

---

PAIN MEDICINE

Postoperative Pain Experience: Results from a National Survey Suggest Postoperative Pain Continues to Be Undermanaged

Jeffrey L. Apfelbaum, MD^*, Connie Chen, PharmD, Shilpa S. Mehta, PharmD, and Tong J. Gan, MD

*Department of Anesthesia and Critical Care, The University Chicago Hospitals, Chicago, Illinois; Pharmacia Corp., Skokie, Illinois; and Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina

Address correspondence and reprint requests to Jeffrey L. Apfelbaum, MD, Department of Anesthesia and Critical Care, The University of Chicago Hospitals, 5841 S. Maryland Ave., MC 4028, Chicago, IL 60637. Address e-mail to j-apfelbaum{at}uchicago.edu

Postoperative pain can have a significant effect on patient recovery. An understanding of patient attitudes and concerns about postoperative pain is important for identifying ways health care professionals can improve postoperative care. To assess patients’ postoperative pain experience and the status of acute pain management, we conducted a national study by using telephone questionnaires. A random sample of 250 adults who had undergone surgical procedures recently in the United States was obtained from National Family Opinion. Patients were asked about the severity of postsurgical pain, treatment, satisfaction with pain medication, patient education, and perceptions about postoperative pain and pain medications. Approximately 80% of patients experienced acute pain after surgery. Of these patients, 86% had moderate, severe, or extreme pain, with more patients experiencing pain after discharge than before discharge. Experiencing postoperative pain was the most common concern (59%) of patients. Almost 25% of patients who received pain medications experienced adverse effects; however, almost 90% of them were satisfied with their pain medications. Approximately two thirds of patients reported that a health care professional talked with them about their pain. Despite an increased focus on pain management programs and the development of new standards for pain management, many patients continue to experience intense pain after surgery. Additional efforts are required to improve patients’ postoperative pain experience.

IMPLICATIONS: A survey of 250 US adults who had undergone a recent surgical procedure asked about their postoperative pain experience. Approximately 80% of patients experienced pain after surgery. Of these patients, 86% had moderate, severe, or extreme pain. Additional efforts are required to improve patients’ postoperative pain experience.

This article has been cited by other articles:

				A. Buvanendran, K. Mitchell, J. S. Kroin, and M. J. Iadarola Cytokine Gene Expression After Total Hip Arthroplasty: Surgical Site versus Circulating Neutrophil Response Anesth. Analg., September 1, 2009; 109(3): 959 - 964. [Abstract] [Full Text] [PDF]

				S. M. Kramer, J. R. May, D. J. Patrick, L. Chouinard, M. Boyer, N. Doyle, A. Varela, S. Y. Smith, and E. Longstaff Instilled or Injected Purified Natural Capsaicin Has No Adverse Effects on Rat Hindlimb Sensory-Motor Behavior or Osteotomy Repair Anesth. Analg., July 1, 2009; 109(1): 249 - 257. [Abstract] [Full Text] [PDF]

				N. Galanis, C. Stavraka, T. Boutsiadou, J. M Kirkos, and G. Kapetanos Postoperative pain management and acupuncture: a case report of meniscal cyst excision Acupunct Med, June 1, 2009; 27(2): 79 - 80. [Abstract] [Full Text] [PDF]

				C. Pasero, K. Puntillo, D. Li, R. A. Mularski, M. J. Grap, B. L. Erstad, B. Varkey, H. C. Gilbert, J. Medina, and C. N. Sessler Structured Approaches to Pain Management in the ICU Chest, June 1, 2009; 135(6): 1665 - 1672. [Abstract] [Full Text] [PDF]

				Qu Shen, G. D. Sherwood, J. A. McNeill, and Zheng Li Postoperative Pain Management Outcome in Chinese Inpatients West J Nurs Res, December 1, 2008; 30(8): 975 - 990. [Abstract] [PDF]

				D. M. Popping, P. K. Zahn, H. K. Van Aken, B. Dasch, R. Boche, and E. M. Pogatzki-Zahn Effectiveness and safety of postoperative pain management: a survey of 18 925 consecutive patients between 1998 and 2006 (2nd revision): a database analysis of prospectively raised data Br. J. Anaesth., December 1, 2008; 101(6): 832 - 840. [Abstract] [Full Text] [PDF]

				K. J. M. Janssen, C. J. Kalkman, D. E. Grobbee, G. J. Bonsel, K. G. M. Moons, and Y. Vergouwe The Risk of Severe Postoperative Pain: Modification and Validation of a Clinical Prediction Rule Anesth. Analg., October 1, 2008; 107(4): 1330 - 1339. [Abstract] [Full Text] [PDF]

				A. S. Habib, W. D. White, M. A. El Gasim, G. Saleh, T. J. Polascik, J. W. Moul, and T. J. Gan Transdermal Nicotine for Analgesia After Radical Retropubic Prostatectomy Anesth. Analg., September 1, 2008; 107(3): 999 - 1004. [Abstract] [Full Text] [PDF]

				Y. Sun, T. J. Gan, J. W. Dubose, and A. S. Habib Acupuncture and related techniques for postoperative pain: a systematic review of randomized controlled trials Br. J. Anaesth., August 1, 2008; 101(2): 151 - 160. [Abstract] [Full Text] [PDF]

				J. McElwain, N. M. Freir, C. L. Burlacu, D. C. Moriarty, D. I. Sessler, and D. J. Buggy The Feasibility of Patient-Controlled Paravertebral Analgesia for Major Breast Cancer Surgery: A Prospective, Randomized, Double-Blind Comparison of Two Regimens Anesth. Analg., August 1, 2008; 107(2): 665 - 668. [Abstract] [Full Text] [PDF]

				R. Jokela, J. Ahonen, M. Tallgren, M. Haanpaa, and K. Korttila Premedication with pregabalin 75 or 150 mg with ibuprofen to control pain after day-case gynaecological laparoscopic surgery Br. J. Anaesth., June 1, 2008; 100(6): 834 - 840. [Abstract] [Full Text] [PDF]

				T. Voepel-Lewis, S. Malviya, A. R. Tait, S. Merkel, R. Foster, E. J. Krane, and P. J. Davis A Comparison of the Clinical Utility of Pain Assessment Tools for Children with Cognitive Impairment Anesth. Analg., January 1, 2008; 106(1): 72 - 78. [Abstract] [Full Text] [PDF]

				T. L. Jones, A. C. Lustig, and L. S. Sorkin Secondary Hyperalgesia in the Postoperative Pain Model Is Dependent on Spinal Calcium/Calmodulin-Dependent Protein Kinase II{alpha} Activation Anesth. Analg., December 1, 2007; 105(6): 1650 - 1656. [Abstract] [Full Text] [PDF]

				E. R. Viscusi, M. Siccardi, C. V. Damaraju, D. J. Hewitt, and P. Kershaw The Safety and Efficacy of Fentanyl Iontophoretic Transdermal System Compared with Morphine Intravenous Patient-Controlled Analgesia for Postoperative Pain Management: An Analysis of Pooled Data from Three Randomized, Active-Controlled Clinical Studies Anesth. Analg., November 1, 2007; 105(5): 1428 - 1436. [Abstract] [Full Text] [PDF]

				S. J. Panchal, C. V. Damaraju, W. W. Nelson, D. J. Hewitt, and J. R. Schein System-Related Events and Analgesic Gaps During Postoperative Pain Management with the Fentanyl Iontophoretic Transdermal System and Morphine Intravenous Patient-Controlled Analgesia Anesth. Analg., November 1, 2007; 105(5): 1437 - 1441. [Abstract] [Full Text] [PDF]

				T. J. Gan and A. S. Habib Adenosine as a Non-Opioid Analgesic in the Perioperative Setting Anesth. Analg., August 1, 2007; 105(2): 487 - 494. [Abstract] [Full Text] [PDF]

				R. A. Kozol and A. Voytovich Misinterpretation of the Fifth Vital Sign Arch Surg, May 1, 2007; 142(5): 417 - 419. [Full Text] [PDF]

				R. W. Hutchison Challenges in acute post-operative pain management Am. J. Health Syst. Pharm., March 15, 2007; 64(6_Supplement_4): S2 - S5. [Abstract] [Full Text] [PDF]

				E. R. Viscusi Emerging treatment modalities: Balancing efficacy and safety Am. J. Health Syst. Pharm., March 15, 2007; 64(6_Supplement_4): S6 - S11. [Abstract] [Full Text] [PDF]

				R. Jokela, J. Ahonen, M. Valjus, T. Seppala, and K. Korttila Premedication with controlled-release oxycodone does not improve management of postoperative pain after day-case gynaecological laparoscopic surgery Br. J. Anaesth., February 1, 2007; 98(2): 255 - 260. [Abstract] [Full Text] [PDF]

				I. Power Fentanyl HCl iontophoretic transdermal system (ITS): clinical application of iontophoretic technology in the management of acute postoperative pain Br. J. Anaesth., January 1, 2007; 98(1): 4 - 11. [Abstract] [Full Text] [PDF]

				S. S. Reuben, A. Buvanendran, J. S. Kroin, and K. Raghunathan The Analgesic Efficacy of Celecoxib, Pregabalin, and Their Combination for Spinal Fusion Surgery Anesth. Analg., November 1, 2006; 103(5): 1271 - 1277. [Abstract] [Full Text] [PDF]

				C. Tong, D. Conklin, and J. C. Eisenach A Pain Model After Gynecologic Surgery: The Effect of Intrathecal and Systemic Morphine Anesth. Analg., November 1, 2006; 103(5): 1288 - 1293. [Abstract] [Full Text] [PDF]

				T. J. Martin, N. L. Buechler, and J. C. Eisenach Intrathecal administration of a cylcooxygenase-1, but not a cyclooxygenase-2 inhibitor, reverses the effects of laparotomy on exploratory activity in rats. Anesth. Analg., September 1, 2006; 103(3): 690 - 695. [Abstract] [Full Text] [PDF]

				R. G. Smith A review of opioid analgesics frequently prescribed by podiatric physicians. J Am Podiatr Med Assoc, July 1, 2006; 96(4): 367 - 373. [Abstract] [Full Text] [PDF]

				E. R. Viscusi and L. N. Schechter Patient-controlled analgesia: Finding a balance between cost and comfort Am. J. Health Syst. Pharm., April 15, 2006; 63(8_Supplement_1): S3 - S13. [Abstract] [Full Text] [PDF]

				P. E. Macintyre, S. Walker, I. Power, and S. A. Schug Editorial I: Acute pain management: scientific evidence revisited Br. J. Anaesth., January 1, 2006; 96(1): 1 - 4. [Full Text] [PDF]

				S. M. Klein, H. Evans, K. C. Nielsen, M. S. Tucker, D. S. Warner, and S. M. Steele Peripheral Nerve Block Techniques for Ambulatory Surgery Anesth. Analg., December 1, 2005; 101(6): 1663 - 1676. [Abstract] [Full Text] [PDF]

				J. C. Rowlingson Postoperative Pain: To Diversify Is to Satisfy Anesth. Analg., November 1, 2005; 101(5S_Suppl): S1 - 4. [Full Text] [PDF]

				I. Power Recent advances in postoperative pain therapy Br. J. Anaesth., July 1, 2005; 95(1): 43 - 51. [Full Text] [PDF]

				D. Gambling, T. Hughes, G. Martin, W. Horton, G. Manvelian, and for the Single-Dose EREM Study Group A Comparison of DepodurTM, a Novel, Single-Dose Extended-Release Epidural Morphine, with Standard Epidural Morphine for Pain Relief After Lower Abdominal Surgery Anesth. Analg., April 1, 2005; 100(4): 1065 - 1074. [Abstract] [Full Text] [PDF]

				P. E. Frasco, J. Sprung, and T. L. Trentman The Impact of the Joint Commission for Accreditation of Healthcare Organizations Pain Initiative on Perioperative Opiate Consumption and Recovery Room Length of Stay Anesth. Analg., January 1, 2005; 100(1): 162 - 168. [Abstract] [Full Text] [PDF]

				M. F. Mulroy, J. M. Neal, and J. E. Pollock What Is Wrong with This Picture of Pain Management? Anesth. Analg., August 1, 2004; 99(2): 627 - 627. [Full Text] [PDF]

				T. J. Gan, G. P. Joshi, E. Viscusi, R. Y. Cheung, W. Dodge, J. G. Fort, and C. Chen Preoperative Parenteral Parecoxib and Follow-Up Oral Valdecoxib Reduce Length of Stay and Improve Quality of Patient Recovery After Laparoscopic Cholecystectomy Surgery Anesth. Analg., June 1, 2004; 98(6): 1665 - 1673. [Abstract] [Full Text] [PDF]