Pain management of Maltese patients after cardiac surgery and their perception of post-operative pain

Abstract

This small-scale exploratory study investigated pain management of Maltese patients following cardiac surgery, and their perception of post-operative pain. A convenience sample of ten patients following coronary artery bypass graft surgery were investigated by means of a structured interview and chart review on three consecutive post-operative days. Quantitative data was collected by means of a vertical visual analogue scale thermometer to measure pain intensity. Present and average pain intensity was mostly mild to moderate, but worst pain was mostly moderate to severe. Analgesics and holding of a cushion to their chest during activities were the factors most frequently identified to reduce their pain. Factors that increased their pain were deep breathing and coughing, the removal of drains, and activity. Although reports of variation of pain intensity with time differed among some patients, most showed a trend of pain peaking on post operative day 2. Pain was mostly located to the chest. The pain management modalities utilized include the use of intravenous morphine boluses as required on day of surgery (mean daily dose 3.6 mg) and on the first post-operative day (mean daily dose 4.3 mg), followed by regular oral coproxamol tablets thereafter. Findings indicate that procedural pain management may be under-utilized. From the discussion, a number of recommendations have been put forward.