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Quality of postoperative pain management after midfacial fracture repair--an outcome-oriented study.
- Gregor F Raschke, Andre Peisker, Ulrich Rieger, Gabriel Djedovic, Arndt Guentsch, Oliver Schaefer, Eric Venth, Marta Gomez Dammeier, and Winfried Meissner.
- Department of Cranio-Maxillofacial & Plastic Surgery, Jena University Hospital, Erlanger Allee 101, 07747, Jena, Germany, raschke.gregor@googlemail.com.
- Clin Oral Investig. 2015 Apr 1; 19 (3): 619-25.
ObjectivesThere is a lack of literature regarding the procedure-specific quality of acute postoperative pain management after midfacial fracture repair. The purpose of the presented prospective clinical study was to evaluate postoperative pain management after surgical repair of midfacial fractures.Materials And MethodsEighty-five adults were evaluated on the first postoperative day following midfacial repair using the questionnaire of the Quality Improvement in Postoperative Pain Management (QUIPS) project. The main outcome measures were patients' characteristics and clinical- and patient-reported outcome parameters.ResultsOverall, pain on the first postoperative day was moderate. A significant correlation between process and outcome parameters could be shown. Duration of surgery above the calculated median was significantly associated with higher maximum pain intensity (p = 0.017). Patients requiring opioids in the recovery room presented significantly higher pain on activity (p = 0.029) and maximum pain (p = 0.035). Sleeping impairment (p = 0.001) and mood disturbance (p = 0.008) were significantly more prevalent in patients undergoing repair of a centrolateral midfacial fracture.ConclusionsQUIPS is a simple and qualified tool to evaluate the procedure specific quality of acute postoperative pain management. Pain on the first postoperative day following midfacial fracture repair seems overall to be moderate. Nearly a third of the patients showed inadequate postoperative pain management. To prevent inadequate postoperative pain management, it is necessary to establish a continued procedure-specific outcome measurement.
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