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CC BY 4.0 · Surg J (N Y) 2022; 08(03): e232-e238
DOI: 10.1055/s-0042-1755623
Original Article

Postoperative Pain, Analgesic Choices, and Ileus: A Snapshot from a Teaching Hospital in a Developing Country

Ameer Al-Jasim 
1   Department of Surgery, Baghdad Teaching Hospital, Medical City Complex, Baghdad, Iraq
,
Alaa A. Aldujaili
2   Department of Anesthesiology, Al-Alwaiya Maternity Teaching Hospital, Baghdad, Iraq
,
Ghaith Al-Abbasi 
3   Department of Surgery, Al-Yarmuk Teaching Hospital, Baghdad, Iraq
,
Hasan Al-Abbasi 
4   Department of Medicine, Baghdad Teaching Hospital, Baghdad, Iraq
,
Saif Al-Sahee
5   Department of Surgery, Tunbridge Wells NHS Trust, Tunbridge Wells, United Kingdom
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Abstract

Background Pain relief can be achieved by diversity of methods with analgesics being the basic form of treatment. Analgesic safety and clinical effectiveness are the core factors in determining the analgesic of choice. One adverse effect of concern with opioids is the postoperative ileus (POI).

Objective In this study, we looked at the severity of postoperative pain, the type of analgesics used to control the pain, and the incidence of POI at Baghdad Teaching Hospital. We hypothesized that we would find an association between the type of analgesia used and POI.

Methods This observational study was conducted among 100 patients who were residents at the general surgery wards of Baghdad Teaching Hospital. A structured questionnaire was employed focusing on types of analgesics, degree of pain control, and the presence of ileus.

Results Sixty-nine percent of patients received a combination of opioids and nonopioids. Moderate-to-severe pain was the most commonly reported category on pain scales. More than half of the patients (57%) were found to have POI during their hospital stay and there was a statistically significant association between the type of analgesia and POI development (p=0.001).

Conclusions A mix of analgesics (opioids and nonopioids) was the most common regimen at our center. The majority of the surgical inpatients reported having moderate-to-severe pain on both pain scales used in this study. Ileus incidence following abdominal surgeries (61%) was significantly higher than the reported incidence worldwide (10–30%). Postoperative ileus has multifactorial causes, one of which is the use of opioids for pain control. Considering the high incidence of ileus in our center and the association we found between the use of opioids and ileus, further studies should look at the doses of opioids used and whether alternative analgesic methods might result in less ileus.

Keywords

postoperative - analgesia - pain relief - opioids - postoperative ileus

Ethical Consideration

All patients received adequate information about the study, then they verbally consented for both participation in the study and the examination by the researchers.

Participants were not asked about their names and all the responses were password-protected and only accessible to the investigators at the time of data analysis.

Data in the patients' files were accessed after getting the approval of the ethical committee at Baghdad Teaching Hospital.


Disclaimer

The authors admit that there was no competing interest or funding source for writing or submitting this article.




Publication History

Received: 10 January 2022

Accepted: 10 May 2022

Article published online:
02 September 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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