• B Geissler, E Neugebauer, R Angster, and J Witte Dagger.
• Klinik für Allgemein- und Viszeralchirurgie, Klinikum Augsburg. surgaugs@klinikum-augsburg.de
• Chirurg. 2004 Jul 1;75(7):687-93.

BackgroundA main target of surgical treatment is to minimize postoperative pain. The aim of this study was to evaluate the benefit of quality management on postoperative pain and to improve pain therapy.MethodsIn a prospective study, postoperative pain was recorded in a total of 700 patients in a general and visceral surgical ward in 2000, 2001, and 2002. Pain was measured on a ten-point visual analogue scale (0 no pain, 10 most severe pain).ResultsApplying the principles of quality management (plan, do, check, act), we analyzed the reasons for high pain scores in detail. After study of the results in 2000, additional recommendations and guidelines for perioperative pain therapy were provided to all the physicians, and the mean visual analogue pain scores decreased by 15% in 2001 and more than 30% in 2002. At baseline, 12% of patients had pain above the threshold of 3 at rest and 5 in motion. These scores could be reduced to 6% and 3% in the two successive years, respectively.ConclusionA simple pain management system in a general surgical ward led to considerable improvement in postoperative pain scores as assessed by visual analogue scale.

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