Background and goal of study: Postoperative pain is quite common and most patients report poor pain control in the postop period, which is linked to worse outcomes. The complexity of acute pain led to the development of acute pain services (APS). Currently there is no optimal model for APS. In our institution, we developed an PACU-based anaesthesiologist-led APS that is responsible for pain management of patients under PCAs or regional catheter-based analgesia and by physician referral. The aim of this study is to evaluate post-operative pain control in our institution and identify risk-factors and areas for improvement.
Materials and methods: During one week period, we assessed all patients who were admitted to our central postanaesthetic care unit for VAS-score at 0 and 24 hrs, age, type of surgery, type of anaesthesia, type of postop analgesia and in-PACU time. Statistical analysis was performed using SPSS 2.0, we applied χ /f-Fisher tests and t-Student/Mann-Whitney tests, considering p-value <0,05.
Results: Data was from 101 patients, 47 female and mean age 62 yrs (23-95). Anaesthetic technique was 80% general anaesthesia, 15% regional anaesthesia, 2% combined anaesthesia and 2% sedoanalgesia. At 0hrs, 82% reported mild pain (VAS<3), 10% moderate pain (VAS 4-6) and 8% severe pain (VAS>6). At 24hrs, 56% had mild pain, 33% moderate pain and 11% severe pain. Postop analgesia was scheduled intravenous (73%) plus surgical site local infiltration (2%), epidural (12%), peripheral nerve block (11%), intravenous PCA (1%) or PCEA (1%). Age (p=0,007) and anaesthetic technique (p=0,002) had a statistically significant relation to pain at 0hrs. Pain at 0hrs (p=0,007) and age (p=0,002) were related to pain at 24hrs. 
Conclusions: Our study shows that there is room for improvement in postop pain control in our institution.  Regional anaesthesia appears to be related to better early postoperative pain control, tough no association with later pain. Good early pain control was associated with better pain control at 24 hours and may be an important predictor of postop pain control. Age was associated with worse postop pain control. This study suggests important predictors of poor pain control that could be used as criteria for APS referral - age and pain upon PACU admission.

Evaluation of acute postoperative pain control and identification of risk factors - experience in a tertiary care center