Surgery patients' number-one fear

USA Today (Society for the Advancement of Education), Feb, 1996

For Americans facing surgery, their greatest dread is the pain they expect to result from it. This is so terrifying to some that they have postponed or canceled an operation, according to a national survey, which also found that more than three-quarters of respondents believe pain is a necessary part of surgery, despite government guidelines advising that patients should not have to suffer from unrelieved pain.

The Roche Pain Management Survey polled 500 Americans, 27% of whom had surgery during the previous five years. Of those who had surgery, 77% reported pain afterwards, with four out of five of those saying they experienced moderate to extreme pain. Seventy-one percent indicated they experienced pain even after receiving medication; 80% reported hey received pain medication on time, although 33% had to ask for it; and 16% had to wait for medication. Thirteen percent used a patient-controlled pump that enabled them to self-administer pain medication.

The Agency for Health Care Policy and Research, U.S. Department of Health and Human Services Guidelines, Acute Pain Management: Operative or Medical Procedures and Trauma," emphasize that unrelieved pain after surgery or trauma is unnecessary and unhealthy; all patients have a right to aggressive treatment that includes prevention or adequate relief of pain@ and effective pain management may shorten hospital stays and reduce costs. The guidelines recommend: * An individualized "pain control plan" developed prior to surgery by health care professionals, the patient, and his or her family. * Frequent assessment and reassessment of the patient's pain. * Use of both drug and non-drug therapies - such as relaxation, massage. or exercise - to prevent and control pain.

Nevertheless, according to the survey, just 53% of all surgical patients were counseled about post-surgical pain by a surgeon, nurse, and - or anesthesiologist before their operations, even though 46% of the nation's hospitals have established procedures to help manage patients' pain. Of the remaining hospitals, 22% reported future plans to implement pain management programs. The two goals most frequently cited for establishing a program were minimizing post-surgical pain and reducing the length of hospital stays.