Incidence and associated factors of post-operative pain after emergency Orthopedic surgery: A multi-centered prospective observational cohort study

Abstract

ABSTRACT Introduction: Emergency orthopedic surgeries are performed on a daily and night basis across the world and, different levels of postoperative pain is commonly reported early and late in the postoperative period. Despite the availability of evidence-based international reports, still it is not clearly stated in Ethiopia. Objective: To determine the incidence and associated factors of post operative pain after Emergency Orthopedics Surgery. Methods: A multi-centered prospective observational cohort study was conducted to determine the incidence and associated factors of postoperative pain after emergency orthopedic surgeries from March 1 to May 30, in 2020. Data was analyzed using Statistical Package for Social Sciences, version 20. To identify the association between outcome variable and independent variables, descriptive statistics, cross tabulation and binary logistic regression were used. Categorical data were analyzed using chi-square test. Adjusted odd ratios were computed with 95% confidence interval and p-value < 0.05 was used to determine the significance of the study. Result: The overall incidence of moderate to severe postoperative pain within the first 24 h after emergency orthopedics surgery was 70.5% (95% CI: 64, 77). On multivariable logistic regression analysis; history of having preoperative pain (AOR: 7.92, 95% CI: 3.04, 20.63), history of preoperative anxiety (AOR: 6.42, 95% CI: 2.59, 15.90), preoperative patient expectation about postoperative pain (AOR: 6.89, 95% CI: 2.66, 17.78) and being general anesthesia (AOR: 4.08, 95% CI: 1.30, 12.77) were significantly associated with moderate to severe postoperative pain after emergency orthopedics surgery. Conclusion: Postoperative pain management should be given a high priority in emergency orthopedics surgery. Appropriate pain management strategy should be implemented to decrease postoperative pain suffering. Factors associated with postoperative pain were; preoperative history of pain and anxiety, patient expectation about postoperative pain and being general anesthesia. Highlights: