Prevalence of acute postoperative pain and factors affecting its control in adult patients following intramedullary nailing for isolated femur fracture at Mulago Hospital

Abstract

Background: The International Association for the Study of Pain (IASP) describes pain as "an unpleasant sensory and emotional experience associated with, or resembling that associated with actual or potential tissue damage." Although pain relief is recognized as a fundamental human right by the World Health Organization (WHO), many patients experience moderate to severe pain during the postoperative period. Globally and regionally, the burden of poorly controlled acute postoperative pain after Orthopaedic surgery is high in many countries, including China (21.89-76%), the United States of America (80-86%), Tanzania (83.9-100%) and Ethiopia (70.5%). There is a growing agreement that inadequate pain management is intolerable, unethical, and illegal, with both legal and professional ramifications. Purpose: To determine the prevalence of postoperative pain and factors affecting its control in adult patients following intramedullary nailing for isolated femur fracture at Mulago Hospital. Patients and methods: This was a cross-sectional study among 109 patients aged ≥ 18 years admitted for intramedullary nailing for isolated femur fracture at Mulago Hospital Orthopaedic Wards. The data collection was collected between February and September 2023. Results: The prevalence of postoperative pain at 24 hrs was 95.41%. The majority (68.81%) of the patients had poor postoperative pain control at 24 hrs. The associated factors did not have an effect on postoperative pain control. The mean age of the respondents was 36.27 (SD: 15.62), with the majority being youth (57.8%). More than half of the respondents were male (72.48%), with only 27.52% female. Conclusion: The prevalence of acute postoperative pain was very high at 95.41% at 24 hrs. Pain control at 24 hours was poor, as 68.81% of the patients had poor postoperative pain control. The factors affecting acute postoperative pain were not significant and may have been masked due to inadequate pain control and low sample size.