Effect of the Evidence-Based and Multidisciplinary Pain Management Program in Patients After Laparoscopic Hepatectomy: A Quasi-Experimental Study.

OBJECTIVE

The study was to explore the clinical effect of the Evidence-Based and Multidisciplinary pain management program for patients after hepatectomy. It examined the program's impacts on postoperative pain, active pain, quality of life, and satisfaction with pain control.

METHODS

A quasi-experimental study was conducted at the Affiliated Hospital of Xuzhou Medical University from May 2024 to April 2025. Fifty-seven patients were enrolled to the experimental (n = 29) and control (n = 28) group. The experimental group was provided evidence-based pain management program by the Acute Pain Service Team. The primary outcome was pain level measured using The Numerical Rating Scale scores. Data were harvested at at the time points of transferring to the ward after surgery, 4 h, 12 h, 24 h, 48 h and 72 h after operation. Secondary outcomes were the Four Grade Functional Activity Score, the Houston Pain Outcome Instrument (HPOI) and quality of life at discharge.

RESULTS

Lower NRS scores were observed in the experimental group compared to the control group at 4 h (t = -3.979, P < 0.001), 12 h (t = -2.426, P = 0.019), 24 h (t = -4.192, P < 0.001), 48 h (t = -2.924, P = 0.005) and 72 h (t = -2.797, P = 0.007) after operation. Significant between-group differences were found in the impact of pain on deep breathing at 12 h (z = -3.472, P = 0.001), 24 h (z = -2.217, P = 0.027), 48 h (z = -2.316, P = 0.021), and 72 h (z = -2.166, P = 0.030), coughing at 24 h (z = -2.446, P = 0.014), 48 h (z = -2.803, P = 0.005), and 72 h (z = -2.580, P = 0.010), turning over at 48 h (z = -2.639, P = 0.008) and 72 h (z = -2.493, P = 0.013), and getting out of bed for activities at 48 h (z = -2.205, P = 0.027) and 72 h (z = -3.151, P = 0.002) after operation. The experimental group showed significant differences from the control group in all dimensions of HPOI. There were no differences regarding psychological and social functions.

CONCLUSION

The Evidence-Based and Multidisciplinary pain management program improved postoperative pain, reduced impact of pain on functional activities, and enhanced satisfaction with pain control, but failed to improve psychological and social functions.