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Acute Pain | Chronic Pain | General

GPs and postoperative pain management

 

Clinical bottom line

General practitioners are frequently required to deal with postoperative pain in patients discharged after surgery. Many need more education and training.


Reference

S Robeaux et al. Acute postoperative pain management at home after ambulatory surgery: a French pilot survey of general practitioners' views. Anesthesia & Analgesia 2002 95: 1258-1262.

Study

General practitioners in Lorraine (2199) who were active or retired were sent a postal questionnaire with 10 questions about postoperative pain after ambulatory surgery. The response rate was 44%.

Results

The potential risk of a patient needing a postdischarge intervention once home, or encountering inadequate acute postoperative pain control at home were major concerns to 74% and 65% of GPs.

Communication with surgical units was poor, with 73% of GPs never receiving instructions about rescue analgesia, and 80% with no information about communication with a designated specialist about pain management.

The frequency of patient contact because of inadequate pain relief after ambulatory surgery is shown in Table 1. Many GPs saw at least one patient a month.

Table 1: Frequency of patient contact because of pain relief failure after ambulatory surgery

Frequency

Percent

More an once a week 5.7
Less than once a week 32
Less than once a month 48
Less than once a year 12
Never 2.5

About two thirds of GPs wanted much more scientific information, guidelines, training and contact with specialists.

Comment

Here we have a paper that starts to uncover what is likely to be a significant problem for GPs. In England, it is not unknown for patients in hospital with severe postoperative pain to call their GPs to ask for analgesics to be brought to hospital. so it isn't just inadequate pain relief at home.