Improving the quality of acute pain services: experiences of treatment of 5212 patients.

Background: In a retrospective, non-randomized, observational study, we compared methods of postoperative analgesia in 5212 cases treated in 2003 and 2004.

Methods: Patients were allocated to two groups: Group A included 2,796 patients treated in 2004; Group B included 2,419 treated in 2003.The acute pain team was staffed by anaesthesiologists who performed daily visits to patients receiving the APS. They dealt with complaints and complications, evaluated the effectiveness of analgesia, and kept records. The visiting anaesthesiologists rotated weekly in group A, and daily in group B.

Results: Analgesic effects, VAS, patient satisfaction, and the incidence of complications were compared between the two groups. The number of patients with an analgesic effect evaluated as "bad" was significantly lower in group A than in group B (p < 0.05). The proportion of patients in whom satisfaction was evaluated as"good"was significantly higher in group A compared to group B (p < 0.05);"moderate" and "bad"satisfaction scores were significantly lower in group A than in group B (p < 0.05). There was no significant difference in the incidence of complications between the two groups (p > 0.05).The number of cases in which analgesia was no longer required was lower in group A than in group B (p < 0.05).

Conclusion: During postoperative management of analgesia by an acute pain service, a weekly rotation of anaesthesiologist staffing is more effective in improving patient satisfaction than a daily rotation.