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Journal of Obstrectic Anaesthesia and Critical Care
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ORIGINAL ARTICLE
Year : 2021  |  Volume : 11  |  Issue : 2  |  Page : 101-105

Effect of implementation of perineal tear pain management programme on pain scores


1 Attending Physician, Adult Anesthesiology, Sidra Medicine, College of Medicine at Qatar University; Clinical Associate Professor in Anesthesiology, College of Medicine at Qatar University; Assistant Professor of Clinical Anesthesiology, Weill Cornell Medical College-Qatar, Doha, Qatar
2 Attending Physician, Adult Anesthesiology, Sidra Medicine, College of Medicine at Qatar University; Honorary Faculty, Clinical Department, College of Medicine, QU Health, Qatar University; Instructor in Clinical Anesthesiology, Weill Cornell Medicine-Qatar, Doha, Qatar
3 Attending Physician, Adult Anesthesiology, Sidra Medicine, College of Medicine at Qatar University; Senior Attending Physician, Adult Anesthesiology, Sidra Medicine; Assistant Professor, Weill Cornell Medical College, Doha, Qatar
4 Attending Physician, Adult Anesthesiology, Sidra Medicine, College of Medicine at Qatar University, Doha, Qatar
5 Division Chief (Acting),Adult Anesthesiology, Sidra Medicine; Assistant Professor of Clinical Anesthesiology,Weill Cornell Medicine-Qatar, Doha, Qatar
6 Attending Physician, Adult Anesthesiology, Sidra Medicine, College of Medicine at Qatar University; Assistant Professor of Clinical Anesthesiology, Weill Cornell Medical College-Qatar, Doha, Qatar; Honorary Senior Lecturer in Regional Anaesthesia, University of East Anglia, UK

Correspondence Address:
Dr. Karunakaran Ramaswamy
Department of Anesthesiology, Sidra Medicine, Doha
Qatar
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/JOACC.JOACC_45_21

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Background: Perineal tear (PT) occurs in more than 85% of the women undergoing vaginal birth and up to 11% of these can be third- and fourth-degree tears and the majority suffer from pain. Poorly managed pain can impact the mother and her capacity to look after the baby. The institution introduced a PT pain management programme (PPP) as part of a quality improvement programme. This paper is a retrospective analysis to determine the effect of this implementation on the pain scores and patient satisfaction. Objective: Does the PT pain management programme improve pain scores at rest 12 and 24 h post-repair? Does the programme improve maternal satisfaction? Methods: A pain management protocol had been implemented for women with PT from January 1, 2020. To assess the effectiveness of the protocol, data were retrieved from electronic medical records (Cerner Millennium) of 100 women who had a PT from January 1, 2019, to March 31, 2019 (pre-PPP), and 96 women who had a PT from April 1, 2020, to July 31, 2020 (post-PPP). We included consecutive women who had second-, third- and fourth-degree tears. Results: A significant difference in the pain scores at 12 h (mean ± SD [difference of means], 95% CI) (2.17 ± 1.11 vs. 4.5 ± 1.65 [2.33], 1.93–2.73, t (194) = 11.54, P < 0.0001) and 24 h (2.17 ± 1.11 vs. 4.32 ± 1.44 [2.15], 1.79–2.52, t (194) = 11.67, P < 0.0001) was found after the introduction of the PPP. The patient satisfaction scores after the programme were improved (8.13 ± 1.35 vs. 5.11 ± 1.72, t (194) = 13.6, P < 0.0001). Conclusions: The implementation of a pain programme for PT is associated with improvements in the pain scores and patient satisfaction. These improvements suggest that pain management protocols should be considered for women with a PT. Further prospective evaluations and work to confirm this finding would be useful in the other institutions.


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