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Journal of Anesthesiology
Journal of Anesthesiology (JA) provides a forum for the publication of scientific research and review articles. The journal publishes original full-length research papers in all areas related to clinical practice and fundamental understanding in anesthesiology. It is devoted to providing excellent patient care, educate future anesthesiologists and conduct laboratory and clinical research in the field.
Article Information
Intraoperative Pain Assessment: The Use of Anesthetized Patient Pain Scale and Cerebral State Monitor

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Pages: 15-20   |   Full PDF Paper  | DOI: 10.11648/j.ja.20130102.11 | Google Scholar
Authors
[01]
Sylvanus Kampo, Department of Anesthesiology, Dalian Medical University, 9 Western Section, Lvshun South Road, Lvshunkou District Dalian City, Liaoning, P. R. China
[02]
Jun Han, Department of Anesthesiology, First Affiliated Hospital of Dalian Medical University, Dalian City, Liaoning, P.R. China; Department of Anesthesia, School of Medicine and Health Science, University for Development Studies, Tamale, Ghana
[03]
Juventus Benogle Ziem, Department of Clinical Laboratory Sciences, School of Medicine & Health Sciences, University for Development Studies, Tamale, Ghana
[04]
Faraja Mpemba, School of Nursing, Dalian Medical University, Dalian, Liaoning P.R. China; School of Nursing, St. John’s University of Tanzania, Dodoma, Tanzania
[05]
Yabasin Iddrisu Baba, Department of Anesthesiology, Dalian Medical University, 9 Western Section, Lvshun South Road, Lvshunkou District Dalian City, Liaoning, P. R. China
[06]
Peng Gao, Department of Anesthesiology, Dalian Medical University, 9 Western Section, Lvshun South Road, Lvshunkou District Dalian City, Liaoning, P. R. China
[07]
Qingping Wen, Department of Anesthesiology, First Affiliated Hospital of Dalian Medical University, Dalian City, Liaoning, P.R. China

To cite this article
Sylvanus Kampo, Jun Han, Juventus Benogle Ziem, Faraja Mpemba, Yabasin Iddrisu Baba, Peng Gao, Qingping Wen, Intraoperative Pain Assessment: The Use of Anesthetized Patient Pain Scale and Cerebral State Monitor, Journal of Anesthesiology. Vol. 1, No. 2, 2013, pp. 15-20. doi: 10.11648/j.ja.20130102.11

Abstract
Background - Pain control in surgical patients remains problematic globally. Intraoperative pain assessment poses significant challenge to many anesthesiologists in poorly resourced countries where monitors and experts are limited. Due to poor intraoperative pain assessment and management, many patients wake up from anesthesia after surgery experiencing moderate to severe pain. It has been reported that about 56% of surgical patients cite pain as their primary concern after surgery. The aim of this study was to use a novel intraoperative pain assessment tool (APPS) and depth of anesthesia monitor (CSM) to assess and score pain in patients undergoing orthopedic procedures under general anesthesia. Methods - Data was prospectively collected for 12-months from 246 patients, aged 20 - 81 years who were undergoing orthopedic surgical procedures. Initial pain intensity was scored using Anesthetized Patients Pain Scale (APPS). The depth of anesthesia was assessed using a CSM prior to pain assessment during surgery. Fentanyl was administered and the pain and depth of anesthesia re-evaluated after 5 to 10min. Results - About 75.6% of patients scored moderate to severe pain with their depth of anesthesia ranging 37-89 score. While 20.7% scored moderate pain with a mean score of 9.56 at the initial pain assessment. A dose of fentanyl, 30 - 50 mcg was administered for pain treatment intraoperatively. Pain was re-evaluated after treatment. About 31.3% scored no pain 49.6% scored moderate pain and 19.1% scored moderate to severe pain. The mean pain intensity scored after treatment was 7.30. Conclusions - Despite adequate depth of anesthesia observed during surgery about 68.7% of surgical patients experienced moderate to severe pain. The use of both APPS and CSM offered adequate intraoperative pain and anesthesia management. Our novel model, APPS has great prospects with clinical application for intraoperative pain assessment.

Keywords
Anaesthetized Patient Pain Scale, Cerebral State Monitor, Intraoperative, Pain Assessment

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