• Br J Anaesth · Oct 2024

    Randomized Controlled Trial Comparative Study

    Effect of a comfort scale compared with a pain numerical rate scale on opioids consumption in postanaesthesia care unit: the COMFORT study.

    • Nicolas Fusco, Ludovic Meuret, Franck Bernard, Hervé Musellec, Laure Martin, Mathilde Léonard, Sigismond Lasocki, Thierry Gazeau, Romain Aubertin, Dorothée Blayac, Florient Leviel, Danguy des DesertsMarcMHIA Clermont-Tonnerre, Department of Anaesthesiology, University of Brest, Inserm, UMR1304-GETBO, Brest, France., Samia Madi-Jebara, Julien Fessler, Sylvain Lecoeur, Cédric Cirenei, Rémi Menut, Clément Lebreton, Stéphane Bouvier, Claire Bonnet, Axel Maurice-Szamburski, Mathilde Cattenoz, Magida El Alami, Elsa Brocas, Christophe Aveline, Ludovic Gueguen, Eric Noll, Aurélie Gouel-Chéron, Olivier Evrard, Mathieu Fontaine, Yên-Lan Nguyen, Céline Ravry, Emmanuel Boselli, Bruno Laviolle, Helene Beloeil, and COMFORT Study Group and the French Society of Anesthesiologists (SFAR) Research Network.
    • CHU Rennes, Anesthesia and Intensive Care Department, Rennes, France; Private Hospital, Anesthesia Department, Saint-Grégoire, France; Hypnosis Institute, Émergences Campus, F-35000 Rennes, France.
    • Br J Anaesth. 2024 Oct 1; 133 (4): 839845839-845.

    BackgroundThe way that pain is assessed in the PACU could impact on postoperative pain and analgesic consumption. However, there is currently no evidence to support this speculation. The authors hypothesised that using a comfort scale reduces postoperative opioid consumption when compared with a standard numerical rating scale (NRS) to evaluate pain in the PACU.MethodsIn this cluster-randomised trial, patients were assessed using either a comfort scale (comfort group) or a pain NRS (NRS group). The primary outcome was the opioid consumption in the PACU. The main secondary outcomes were postoperative pain, nausea and vomiting, length of stay in the PACU, and satisfaction.ResultsOf 885 randomised patients, 860 were included in the analysis. Opioid consumption in the PACU was comparable in the comfort and NRS groups (median [interquartile range [IQR] 0 (0-5) vs 0 (0-6); P=0.2436), irrespective of the type of surgical procedure. The majority of patients did not need any postoperative opioid (59% in the comfort group and 56% in the NRS group, P=0.2260). There was no difference in postoperative pain, nausea and vomiting, time to reach an Aldrete score ≥9 after extubation, and global satisfaction.ConclusionsUsing a comfort scale to assess pain in the PACU did not spare any opioid compared with use of a standard NRS. Further studies focusing on patients at risk of increased postoperative opioid consumption are necessary.Clinical Trial RegistrationNCT05234216.Copyright © 2024 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.

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