Postoperative pain assessment after middle ear surgery

Background. The purpose of this work was to assess postoperative pain management after middle ear surgery. Materials and methods. In a prospective clinical study, 73 adults were evaluated on the first postoperative day after middle ear surgery using the questionnaire of the Germany-wide project QUIPS (quality improvement in postoperative pain management). The main outcome measures were patients' characteristics, pain parameters, outcome, and pain therapy process parameters. Results. Overall, pain on the first postoperative day was mild. Pain management consisted predominately of premedication with midazolam, remifentanil intraoperatively, metamizole in the recovery room and on the ward. Otherwise healthy patients suffered significantly more from pain than patients with reduced general condition in univariate and multivariate analyses. About half of the patients demanded pain relief on the ward. Despite immediate pain management with nonopioids and/or opioids, these patients had significantly more maximal pain and were less satisfied with overall pain therapy than patients not demanding pain therapy. Discussion. QUIPS is a simple tool to evaluate the quality of in-hospital postoperative pain management following ear surgery. Pain on the first postoperative day seems to be moderate but should be improved for patients demanding more analgetics despite baseline pain therapy on the ward.