Administration of post-operative analgesia

Pain is one of the major problems encountered by patients who have undergone surgery. The relief of pain is an important part of their treatment, and is both a nursing and a medical responsibility. Analgesics, both narcotic and non-narcotic, are usually prescribed by doctors on a pro re nata, or ‘as needed\u27 basis. The responsibility for administration lies with the nurses, and they choose the type and quantity of drug to be given. Research into the area of pain relief has shown that both nurses and doctors need further education in the judicious use of analgesics, particularly narcotics. This study was conducted on 27 patients on two orthopaedic wards in a public hospital. Using the patients\u27 drug charts and information obtained from nurses, the relationship between the type of drug (narcotic and non-narcotic) and quantity of analgesics administered post-operatively, and several environmental and patient related variables was investigated. The study tested whether any statistically significant correlations exist between the variables (gender of the patient, age of the patient, the nurses\u27 perception of the severity of injury, the person initiating the analgesia, time lapsed from surgery, and the shift the nurse is working) and the type and quantity of analgesia administered. It was hypothesised that positive correlations would be found for all the variables. Results showed no relationship between the age or gender of the patient and analgesia administered. A negative correlation was found between the nurses\u27 perception of the severity of the patient\u27s injury and the quantity of analgesia given. There was no difference between the quantity or type of analgesia administered during different shifts. A pattern of administration was found for the first 48 hours post-operatively. Results also showed a significant correlation between the person initiating the administration of analgesic and the type of analgesic given. From these findings it was recommended that further investigation of the correlations be done using a larger population from different wards and social background. Education of both nurses and patients is essential for pain management. Some ways in which this can be improved are by using pain measurement instruments to enhance nurses 1 assessment skills, incorporating pain management skills into both basic and in service education for nurses, and implementing a \u27pain management nurse specialist’ to educate patients pre-operatively and serve as a resource person for nursing staff