ADEQUACY OF CURRENT ANALGESIA PRACTICES AMONG ADULTPATIENTS UNDERGOING LAPAROTOMY AT MOI TEACHING ANDREFERRAL HOSPITAL, ELDORET, KENYA
Abstract
Objective: The study sought to determine the adequacy of current analgesia practices used in the management of acute post-operative pain among adult patients who undergo laparotomy at Moi Teaching and Referral Hospital,Eldoret, Kenya.
Design: A descriptive study.
Setting: The study was carried out at Moi Teaching and Referral Hospital, a
public tertiary hospital in Eldoret, Kenya, which has a total bed capacity of 1000, with 32 beds designated for gynecological patients, 42 for male general surgical patients, and 48 for female general surgical cases.
Participants: A total of 241 adult participants were systematically recruited.
Main outcome measures: The dependent variables of interest were pain score, analgesics, analgesia modalities, and patients’ satisfaction. Independent variables included demographics (sex, age, place of origin) and clinical data (elective/emergency). Data was collected through patients’ interviews and review of anesthetic charts and treatment sheets to complete a structured questionnaire. Categorical data were summarized, and the findings were presented in figures. For the categorical variables, odds ratios were calculated at a 95% confidence interval, and p-values <0.05 were considered statistically significant.
Results: The mean age of participants was 45.4 years, with a female
predominance at 58.1%. The majority of laparotomies were performed emergently (97.1%), with the most common abdominal procedure being exploratory laparotomy (41.9%). The proportion of patients with moderate or severe pain at the post-anesthetic care unit at 24-hour and 48-hour intervals was 56%, 17%, and 6.2%, respectively. Paracetamol plus tramadol was the most used combination at both 24 (31.1%) and 48 (28.9%) hour intervals. The Cochran–Armitage test showed a statistically significant (P< 0.001) linear trend in pain score across the assessment periods.
Conclusion: Acute post-operative pain management at Moi Teaching and
Referral Hospital, Eldoret, is inadequate, as evidenced by many participants experiencing moderate to severe pain, with limited utilization of opioid based systemic analgesics.
