Evolution of Management of Postoperative Pain in Spain: A Nationwide Survey of Organizational Structure and Clinical Practice
Maria A. Perez-Herrero, Gustavo Illodo Miramontes, Neus Esteve Pérez, Servando López Alvarez, Juan Carlos Luís Navarro, Blanca Martínez Serrano, Santiago Montesinos Fadrique, Sandra Fernández Caballero, María Teresa Fernández Martin, Agustín Mendiola de la Osa, Antonio Montes PérezBackground
Hospitals require standardized processes to effectively manage patients with acute postoperative pain. We aim to evaluate the current pain management practices in Spain through a cross‐sectional study, updating the findings from a previous audit conducted in 2012.
Methods
An online questionnaire was mailed to anesthesiologists in Spain. Responses were stratified based on the hospital size (< 200 or ≥ 200 beds). Categorical variables were presented as percentages with a 95% confidence interval, while continuous variables were expressed as median and interquartile range.
Results
The survey received responses from 67.9% ( n = 127) of hospitals with ≥ 200 beds. 70.1% of large hospitals had an acute pain service (APS) and a hospital‐wide acute pain management program (APMP). Concerning large hospitals, full‐time pain physicians were available in 30.3% of large hospitals, and 41.6% had full‐time nurses dedicated to pain management; 40.2% of patients received written information about postoperative pain; 89.0% of participants reported that their hospital used a standardized scale for assessing postoperative pain; 79.5% had pain treatment protocols; professional training in postoperative pain was organized in 46.6% of cases; and 51.2% considered that the acute postoperative pain was well managed in their hospital.
Conclusion
Twelve years later, our study shows (in hospitals ≥ 200 beds), there has been an increase in the percentage of centers with APS or APMP, the proportion of nurses with full‐time dedication, and the assessment and documentation of pain. However, the implementation of protocols, pain management training, and the analysis of pain‐related indicators have worsened. Improvements are necessary to implement standardized acute postoperative pain management.