Zusammenfassung
Fragestellung
Ziel der vorliegenden Studie war es, herauszufinden, ob im Rahmen einer Patientenversorgung durch den postoperativen Schmerzdienst eine Korrelation zwischen der Patientenzufriedenheit und dem Schmerzniveau feststellbar ist.
Methodik
150 allgemeinchirurgische, gynäkologische und orthopädische Patienten, die postoperativ eine patientenkontrollierte epidurale Analgesie erhielten, wurden nach Ende der Schmerztherapie in Bezug auf ihre Zufriedenheit mit der analgetischen Therapie befragt.
Ergebnisse
Die Patienten beurteilten die postoperative Schmerztherapie insgesamt wie folgt: sehr gut 43,9%; gut 43,9%, befriedigend 8,2%, ausreichend 1,4%; mangelhaft 1,4%; ungenügend 1,4%. Die Berechnung der Korrelation zwischen Patientenzufriedenheit und erinnertem maximalem Schmerzniveau (VAS-Skala 0–100 mm) ergab eine schwache Korrelation (r=0,266; p=0,001).
Schlussfolgerung
Die Evaluation der Betreuung durch einen postoperativen Schmerzdienst ergibt eine hohe Patientenzufriedenheit, die nicht mit dem subjektiven Schmerzempfinden korrelierte.
Abstract
Introduction
The evaluation of patients' satisfaction and outcome after surgery is of increasing importance. An optimized postoperative pain management may contribute substantially to this important goal.
Methods
After approval of the local ethics committee and written informed consent, 150 adult patients receiving epidural catheters for postoperative pain management were evaluated over 1 week postoperatively with respect to their satisfaction with the pain therapy and incidence of side effects. All patients received a continuous epidural infusion with ropivacaine 0.2% plus sufentanil 0.5 μg/ml via a PCEA pump (basal rate 6–8 ml/h, bolus 2 ml, lockout time 5 min). For assessment of pain the VAS scale (0–100 mm) was used, and patients' satisfaction was evaluated using a numeric rating scale (1–6, 1=very good, 6=very dissatisfied).
Results
Of the patients, 95 were operated in general surgery, 32 in orthopedics, and 23 in gynecology. Time of treatment with epidural catheters (71% thoracic, 29% lumbar catheters) was 5.1±2.9 days. Of the patients, 87.8% evaluated the postoperative pain service as very good or good, and 89% of the patients would choose the same pain therapy again. Side effects mainly consisted in bladder dysfunction (19%) and intermittent motor blockade (18%) especially with lumbar catheters. Correlation between patient satisfaction and the remembered maximum pain levels was low (r=0.266).
Conclusion
Evaluation of patients' satisfaction with postoperative epidural pain therapy resulted in a high degree of satisfaction without correlation between patients' satisfaction and recalled maximum pain levels. These results, including side effects and special problems during pain therapy, provide motivation to further improve postoperative pain management.
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Gottschalk, A., Freitag, M., Liehr, K. et al. Korreliert die Patientenzufriedenheit mit dem Schmerzniveau bei der Anwendung von patientenkontrollierter Epiduralanalgesie?. Schmerz 18, 145–150 (2004). https://doi.org/10.1007/s00482-003-0241-y
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DOI: https://doi.org/10.1007/s00482-003-0241-y