• S Kuhn, K Cooke, M Collins, J M Jones, and J C Mucklow.
• Department of Clinical Pharmacology, North Staffordshire Health Authority, Stoke on Trent.
• BMJ. 1990 Jun 30; 300 (6741): 1687-90.

ObjectiveTo assess patients' satisfaction with postoperative pain relief.DesignA descriptive and questionnaire study of patients' experience.SettingTwo surgical and two gynaecological wards.Patients50 Patients admitted to hospital for cholecystectomy and 51 admitted for hysterectomy.Main Outcome MeasuresVisual analogue scales with no divisions were completed by the patients immediately after each dose of postoperative analgesia was administered throughout their stay in hospital. A questionnaire completed on the fifth postoperative day recorded patients' recollections of their experience. Opinions were also sought from medical and nursing staff.ResultsDuring the first 24 hours after surgery recorded pain levels were 60% of the maximum and were not influenced by age, sex, or the type of operation performed. The median interval between the return of pain and a further injection of analgesic was 2 hours (interquartile range 1 to 3.5 hours). Expectations of pain relief were low, and for 70% of the patients the pain was at least as bad as they had expected. Only half of the medical and nursing staff questioned thought that postoperative analgesia should relieve pain completely; drugs were prescribed and administered with too little attention to the patient's response and too much concern about adverse effects and opioid dependence.ConclusionsThe results suggest that the standard of postoperative pain relief is poor because of inadequate education of patients in what to expect (and demand), and of medical and nursing staff in how to prescribe and administer analgesia with reference to individual drug response.

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