Research Article

Patient Communication before General Anesthesia to Reduce Post-Operative Pain and Agitation after Endoscopic Sinus Surgery: A Randomized Clinical Trial

Abstract

Background: Patients often name post-operative pain as the most horrifying aspect of the surgery. The purpose of this study was to evaluate the effect of communication with patients on post-operative pain and agitation in the patients recovering from endoscopic sinus surgery.
Methods: This was a randomized clinical trial. Sixty patients scheduled for endoscopic sinus surgery were randomly allocated to control and intervention groups (30 patients in each group). A supportive and informative session was established for 20-30 minutes in two stages for the intervention group while the control group received routine information. After surgery, pain and agitation were assessed using the non-verbal pain scale, visual analog scale and Riker's sedation-agitation score.
Results: The average pain scores in the recovery room by non-verbal pain scale and visual analog scale were (3.4±1.6) and (6.2±3.0) for the control group and (1.2±1.5) and (3.0±3.3) for the intervention group, respectively (P≤0.001). The average agitation score in the recovery room for the control group and the intervention group were (4.6±0.6) and (4.1±0.3), respectively (P=0.008).
Conclusion: The results demonstrate that simple communication techniques before the surgery can be effective in reducing post-operative pain and agitation in patients recovering from endoscopic sinus surgery.
This clinical trial was registered from IRCT with registration number IRCT201404278589N3.

 

Huang N, Cunningham F, Laurito CE, Chen C. Can we do better with postoperative pain management? Am J Surg. 2001;182(5):440-8.

Gillies ML, Parry-Jones WL, Smith LN. Post-operative pain in adolescents: a pilot study. J Clin Nurs. 1997; 6(1):77-8.

Rawal N. Postoperative pain management in day surgery. Anaesthesia. 1998; 53 Suppl 2:50-2.

Gillies ML, Smith LN, Parry-Jones WL. Postoperative pain assessment and management in adolescents. Pain. 1999; 79(2-3):207-15.

Mac Lellan K. Postoperative pain: strategy for improving patient experiences. J Adv Nurs. 2004; 46(2):179-85.

Klopper H, Andersson H, Minkkinen M, Ohlsson C, Sjostrom B. Strategies in assessing post operative pain--a South African study. Intensive Crit Care Nurs. 2006; 22(1):12-21.

Sjoling M, Nordahl G, Olofsson N, Asplund K. The impact of preoperative information on state anxiety, postoperative pain and satisfaction with pain management. Patient Educ Couns. 2003; 51(2):169-76.

Lin LY, Wang RH. Abdominal surgery, pain and anxiety: preoperative nursing intervention. J Adv Nurs. 2005; 51(3):252-60.

Leykin Y, Casati A, Rapotec A, Dalsasso M, Barzan L, Fanelli G, et al. Comparison of parecoxib and proparacetamol in endoscopic nasal surgery patients. Yonsei Med J. 2008; 49(3):383-8.

Yu D, Chai W, Sun X, Yao L. Emergence agitation in adults: risk factors in 2,000 patients. Can J Anaesth. 2010; 57(9):843-8.

Manyande A, Berg S, Gettins D, Stanford SC, Mazhero S, Marks DF, et al. Preoperative rehearsal of active coping imagery influences subjective and hormonal responses to abdominal surgery. Psychosom Med. 1995; 57(2):177-82.

Owen H, McMillan V, Rogowski D. Postoperative pain therapy: a survey of patients' expectations and their experiences. Pain. 1990; 41(3):303-7.

Salmon P. The reduction of anxiety in surgical patients: an important nursing task or the medicalization of preparatory worry? Int J Nurs Stud. 1993; 30(4):323-30.

Roditi D, Robinson ME. The role of psychological interventions in the management of patients with chronic pain. Psychol Res Behav Manag. 2011; 4: 41-9.

Odhner M, Wegman D, Freeland N, Steinmetz A, Ingersoll GL. Assessing pain control in nonverbal critically ill adults. Dimens Crit Care Nurs. 2003; 22(6):260-7.

Riker RR, Fraser GL, Simmons LE, Wilkins ML. Validating the Sedation-Agitation Scale with the Bispectral Index and Visual Analog Scale in adult ICU patients after cardiac surgery. Intensive Care Med. 2001; 27(5):853-8.

Dimatteo MR. The role of effective communication with children and their families in fostering adherence to pediatric regimens. Patient Educ Couns. 2004; 55(3):339-44.

Lepouse C, Lautner CA, Liu L, Gomis P, Leon A. Emergence delirium in adults in the post-anaesthesia care unit. Br J Anaesth. 2006; 96(6):747-53

Kaptchuk TJ, Kelley JM, Conboy LA, Davis RB, Kerr CE, Jacobson EE, et al. Components of placebo effect: randomised controlled trial in patients with irritable bowel syndrome. Bmj. 2008; 336(7651):999-1003.

Gramke HF, de Rijke JM, van Kleef M, Raps F, Kessels AG, Peters ML, et al. The prevalence of postoperative pain in a cross-sectional group of patients after day-case surgery in a university hospital. Clin J Pain. 2007; 23(6):543-8.

Ommen O, Janssen C, Neugebauer E, Bouillon B, Rehm K, Rangger C, et al. Trust, social support and patient type--associations between patients perceived trust, supportive communication and patients preferences in regard to paternalism, clarification and participation of severely injured patients. Patient Educ Couns. 2008; 73(2):196-204.

Files
IssueVol 3 No 3 (2017): Summer QRcode
SectionResearch Article(s)
Keywords
communication pain agitation general anesthesia surgery
Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Mazloom SR, Navidi F, Hajimohammadi F, Amirzargar B, Ghanbari Hashemabadi BA, Majidi MR, Jalaeian R, Behzadi M, Jafari M. Patient Communication before General Anesthesia to Reduce Post-Operative Pain and Agitation after Endoscopic Sinus Surgery: A Randomized Clinical Trial. Arch Anesth & Crit Care. 2017;3(3):348-353.