Introduction The WHO analgesic ladder is a well-recognised tool for managing post-operative pain. The aim of this prospective study was to identify if patients undergoing elective colorectal surgery were both prescribed and receiving adequate and appropriate oral analgesia.
Method All patients who underwent elective colorectal surgery over a 4 week period were included. Regular and as required oral analgesia prescribed and administered on day 1, 3 and 5 post-op were recorded. The pain score at these time intervals and the use of any additional local anaesthetic were also recorded.
Results 17 patients met the criteria for inclusion. 4 patients had rectus sheath catheters placed, 3 had patient-controlled analgesia and 5 had a “one shot” spinal bolus.
Day 1 post-op all patients were prescribed regular paracetamol and 53% received this. Additional analgesia was required in 58% of patients, half of whom did not receive their regular oral analgesia and 8 were prescribed only paracetamol regularly. 24% of all patients on day 1 post-op had a pain score ≥1.
On day 3 post-op all patients were prescribed regular paracetamol and 50% received this. Of those who required supplementary analgesia on day 3, only paracetamol was given regularly. 13% of all patients on day 5 post-op had a pain score ≥1.
Half of patients on day 5 post-op did not receive their regularly prescribed paracetamol. Of these patients, 2 required addition analgesia. All patients had a pain score of 0 on day 5.
Conclusion At day 1 and 3 post-colorectal surgery not all patients received adequate analgesia despite oral analgesia being prescribed, although at day 5 all patients were pain free. It is apparent that the WHO analgesic ladder is not being adhered to for management of pain post-colorectal surgery.
Disclosure of interest None Declared.
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