Background and Goal of Study:Acute postoperative pain is a large problem worldwide, as it is not being
adequately recognised or managed appropriately. The majority of patients following an operation (between
50% to over 80%) will report unsatisfactory pain levels. There is a paucity of identifiable and published data
that accurately highlights the extent of the problem in the South African setting, in terms of acute postoperative
pain management and levels of patient satisfaction with the care offered.
The aim of this study was to describe the peri-operative pain management of TAH patients at RMMCH
using the PAIN-OUT Questionnaire.
Materials and Methods:A consecutive, convenience sampling method was used to include all post-TAH
patients operated on in a three month period at Rahima Moosa Mother and Child Hospital. Patients
completed the PAIN OUT patient questionaire between 6 and 24 hours after surgery. The PAIN OUT
process questionnaire was completed at the same time.
Results and Discussion:76 patients were recruited into the study from September to November 2015.The
average age of the sample population was 46.14 years (SD 8.82), ages ranged from 31 to 80 years. The
majority of cases had volatile general anaesthetics. Eleven patients were anaesthetised using targetcontrolled
infusions (TCIs) or intravenous anaesthetics, with Propofol and Remifentanil.In 50% of cases
transversus abdominus plane (TAP) blocks were performed intraoperatively.Forty (52.63%) of the
patients received a combination of Fentanyl and Morphine intra-operatively. Seventeen (22.37%)
patients had a combination of Sufentanil and Morphine while four patients (5.26%) received Alfentanil and
Morphine. The use of non-opioid analgesics varied. Post-operatively, the maximum pain score of 10 was
chosen by 17 of the patients (22.36%). The lowest score given was 1, selected twice (2.63%). There was a
median score rating of 8.
Conclusion(s):This study highlighted the unacceptably high levels of post-operative pain reported by
patients. It also showed that analgesic medication administration was not prioritised by the staff in the postoperative
ward by the time the patients were interviewed on the first post-operative day. Improvements in delivery of prescribed analgesic medication post-operatively needs to be adequately ensured and staff
trained in the importance of managing pain appropriately.

Acknowledgements (optional):IASP Grant for access to the PAIN OUT database

10 / The Peri-operative Pain Managment of Total Abdominal Hysterectomy Patients at an Academic Hospital