Effect of a comfort scale compared with a pain numerical rate scale on opioids consumption in postanaesthesia care unit: the COMFORT study.
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Fusco Nicolas, Meuret Ludovic, Bernard Franck, Musellec Hervé, Martin Laure, Léonard Mathilde, Lasocki Sigismond, Gazeau Thierry, Aubertin Romain, Blayac Dorothée, Leviel Florient, Danguy des Deserts Marc, Madi-Jebara Samia, Fessler Julien, Lecoeur Sylvain, Cirenei Cédric, Menut Rémi, Lebreton Clément, Bouvier Stéphane, Bonnet Claire, Maurice-Szamburski Axel, Cattenoz Mathilde, El Alami Magida, Brocas Elsa, Aveline Christophe, Gueguen Ludovic, Noll Eric, Gouel-Chéron Aurélie, Evrard Olivier, Fontaine Mathieu, Nguyen Yên-Lan, Ravry Céline, Boselli Emmanuel, Laviolle Bruno, Beloeil Helene, COMFORT Study Group and the French Society of Anesthesiologists (SFAR) Research Network
Аннотация
METHODS: In this cluster-randomised trial, patients were assessed using either a comfort scale (comfort group) or a pain NRS (NRS group). The primary outcome was the opioid consumption in the PACU. The main secondary outcomes were postoperative pain, nausea and vomiting, length of stay in the PACU, and satisfaction.
RESULTS: Of 885 randomised patients, 860 were included in the analysis. Opioid consumption in the PACU was comparable in the comfort and NRS groups (median [interquartile range [IQR] 0 (0-5) vs 0 (0-6); P=0.2436), irrespective of the type of surgical procedure. The majority of patients did not need any postoperative opioid (59% in the comfort group and 56% in the NRS group, P=0.2260). There was no difference in postoperative pain, nausea and vomiting, time to reach an Aldrete score ≥9 after extubation, and global satisfaction.
CONCLUSIONS: Using a comfort scale to assess pain in the PACU did not spare any opioid compared with use of a standard NRS. Further studies focusing on patients at risk of increased postoperative opioid consumption are necessary.
CLINICAL TRIAL REGISTRATION: NCT05234216.