Implementation and evaluation of postoperative pain management protocols in older adults.

OBJECTIVES

To evaluate if the two new post-operative pain management protocols for older patients were well prescribed, administered, and monitored.

METHODS

A retrospective clinical audit of 100 older patients who were prescribed these protocols was conducted.

RESULTS

Only 17% of patients met all prescriptions criteria (age> 75 gt; 75 years, opioid naïve patient, recent surgery, no co-prescribing of inappropriate analgesics for older patients, no duplicate prescription and tramadol dosage following recommandations). Prescriptions issues were mostly inappropriate analgesic prescriptions (29%), duplicate medications (28%), and tramadol under-dosing (88%). None of the patients received 100% of the prescribed antalgics doses, administrations compliance was below 50%, only 8% for morphine. Pain was assessed rigorously (99%), monitoring for opioid-related side effects, like respiratory (6%) and vigilance (12%), was incomplete.

CONCLUSIONS

This highlights challenges in implementing new postoperative analgesia protocols in a healthcare facility.