Quality of Postoperative Pain Management Following Thoracic Surgery
NCT ID: NCT01616550
Last Updated: 2013-09-16
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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COMPLETED
250 participants
OBSERVATIONAL
2012-09-30
2013-09-30
Brief Summary
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Hypothesis: Postoperative pain management following thoracotomy or thoracoscopy is still suboptimal despite the evidence that adequate pain relief improves outcome.
Detailed Description
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Currently, approximately 1000 thoracic surgeries are performed in our hospital annually. Many of these surgeries that previously required a thoracotomy incision are now performed under Video-Assisted Thoracoscopy Surgery (VATS). Although VATS is known to be less invasive and causes less pain than thoracotomy, some patients still experience considerable pain following thoracoscopy especially during the first hours following surgery.
Thoracic epidural has emerged as the preferred pain control technique following thoracotomy. However, the role of epidural analgesia after thoracoscopy remains debatable. The ideal postoperative analgesia regimen for the short-duration but intense pain related to thoracoscopy has not been elucidated. Paravertebral blockade is an alternative to epidural analgesia. However, the duration of pain relief associated with this technique may vary from 4 to 48 hours. Systemic opioids given through patient-controlled devices may be used after thoracic surgery but the analgesic effect can be limited and undesirable side-effects may occur.
This prospective observational study will investigate the quality of pain management following thoracic surgery and assess patient's and nurse's satisfaction regarding pain relief in a teaching hospital.
Methods:
Patients scheduled for elective thoracic surgery to be performed by thoracotomy or thoracoscopy will be considered for this prospective observational study.
The surgical approach and pain management plan will not be modified by the patient's participation to the study. According to standard practice in our hospital, pain will be assessed using a Verbal Numeric Scale from 0 to 10.
Type of analgesic technique, consumption of opioid and non-opioid drugs, type and duration of surgery will be noted. Side-effects attributable to analgesia and associated treatment will be recorded. Length of stay in the recovery room, step-down unit and in the hospital will also be recorded. Postoperative complications will be assessed.
Patients will be invited to complete the short form of the "Brief Pain Inventory". They will be asked to grade their satisfaction with pain relief using a scale from 1 to 4 (1= very unsatisfied, 4= very satisfied). Nurses will be asked to provide their opinion on patient's pain relief, ability to move and collaboration.
Conditions
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Keywords
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Study Design
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COHORT
PROSPECTIVE
Study Groups
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Patients undergoing thoracic surgery
Assessment of postoperative pain management in patients undergoing elective thoracoscopy or thoracotomy in a teaching hospital
Assessment of pain using the Brief Pain Questionnaire
Patients will complete this questionnaire daily from surgery until discharge from the hospital
Assessment of pain relief using a Verbal Numeric Scale (VNS)
Patients will assess their pain daily from surgery until discharge from the hospital using the VNS
Assessment of patient' satisfaction with pain relief
Will be assessed three times a day using a scale from 1 to 4 (1= very unsatisfied, 4= very satisfied)
Nurse's satisfaction with patient's pain relief and recovery
Will be assessed three times a day using a scale from 1 to 4 (1= very unsatisfied, 4= very satisfied)
Interventions
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Assessment of pain using the Brief Pain Questionnaire
Patients will complete this questionnaire daily from surgery until discharge from the hospital
Assessment of pain relief using a Verbal Numeric Scale (VNS)
Patients will assess their pain daily from surgery until discharge from the hospital using the VNS
Assessment of patient' satisfaction with pain relief
Will be assessed three times a day using a scale from 1 to 4 (1= very unsatisfied, 4= very satisfied)
Nurse's satisfaction with patient's pain relief and recovery
Will be assessed three times a day using a scale from 1 to 4 (1= very unsatisfied, 4= very satisfied)
Eligibility Criteria
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Inclusion Criteria
* ASA physical status 1-3
* Patients undergoing elective thoracic surgery (thoracotomy/thoracoscopy)
Exclusion Criteria
* Presence of a coexisting chronic pain syndrome
* The inability to understand a verbal numeric pain scale (VNS) despite previous instruction
* Patient refusal
18 Years
80 Years
ALL
No
Sponsors
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Centre hospitalier de l'Université de Montréal (CHUM)
OTHER
Responsible Party
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Principal Investigators
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Daniel Boudreault, MD, FRCPC
Role: PRINCIPAL_INVESTIGATOR
Centre hospitalier de l'Université de Montréal (CHUM)
Locations
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Centre Hospitalier de l'Université de Montréal
Montreal, Quebec, Canada
Countries
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Other Identifiers
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DB 2012-001
Identifier Type: -
Identifier Source: org_study_id