Pain Assessment and Management in Patients After Abdominal Surgery From PACU to the Postoperative Unit Jane R. Wilding, RN, MN, Dip App Sci (Nsg), Grad Dip Nsg (Periop), Dip Bus, Elizabeth Manias, RN CertCritCare, BPharm, MPharm, MNStud, PhD, FRCNA, Diarmuid G. L. McCoy, MB BCh, BAO(NUI), FFARCSI, FFPMANZCA, DPM(CARCSI) The aim of this exploratory study was to determine the effectiveness of pain relief for surgical patients (N 5 52) in transition from the PACU to the post- operative unit. The study also explored whether there was an association between a verbal numeric pain score (0 to 10) on discharge from the PACU and the duration of time until analgesia was administered in the postoperative unit. Information was obtained about pain management, time of discharge, and patient pain scores on discharge from the PACU, as well as pain scores and the time of first analgesic administered in the postoperative unit. Most patients were discharged from the PACU with a pain score in the mild range (0 to 4), indicating reasonable pain relief. An association existed between the pain score on discharge from the PACU and the duration of time to the first analgesic dose administered on the postoperative unit. Keywords: postoperative pain, PACU pain, pain assessment, pain manage- ment, research. Crown Copyright Ó 2009 Published by Elsevier Ltd. All rights reserved. PAIN IS A COMMON experience in patients recovering from surgery. A key responsibility for nurses working in the postanesthesia care unit (PACU) is to provide pain re- lief for the postoperative patient. Patients emerging from anesthesia after surgery often wake with pain or discom- fort that may be better or worse than the preoperative state or expectation. Nursing management of pain in PACUs 1-4 and postopera- tive units is well documented 5-11 ; however, the quality of the continuity of pain management between the two environments is unknown. This study attempted to iden- tify the PACU discharge pain score that maintained patient comfort on transfer to the postoperative unit for an opti- mum period of time. It would be valuable for PACU nurses to know that patients have pain relief for a continuing pe- riod of time after leaving the PACU as a result of their nurs- ing care. This information would provide PACU nurses with confidence that the initial pain relief they provide continues to be effective after discharge from the PACU. Researchers examining pain management have focused on specific stages of patient care, which often did not include the transition from the PACU to the postoperative unit. For example past research has considered patients’ pain inten- sities using a visual analog scale (VAS) 4,12 on the day of surgery, 1 at 48 hours after surgery, 13,14 or during a set obser- vational period. 2,15 Aside from two studies, there is little published evidence describing the transition of pain man- agement from one perioperative clinical setting to an- other. 13,16 Ravaud et al 13 undertook a randomized clinical trial to assess the effects of an educational program de- signed to improve nurses’ assessment and documentation of postoperative pain in the PACU and postoperative unit 48 hours after surgery. The pain score was measured more frequently on discharge from the PACU and on the postoperative unit at 48 hours. The improved rates of Jane R. Wilding is the Perioperative Clinical Nurse Educator, Bar- won Health, Victoria, Australia; Elizabeth Manias is Associate Head (Research) and Equity and Staff Development Coordinator, School of Nursing and Social Work, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia; and Dia- rmuid G.L. McCoy is a Consultant Specialist in Anaesthesia and Pain Management, Barwon Health, Victoria, Australia. Address correspondence to Jane R. Wilding, Barwon Health, Centre for Education and Practice Development, PO Box 281, Geelong, Victo- ria 3220, Australia; e-mail address: janew@barwonhealth.org.au. Crown Copyright Ó 2009 Published by Elsevier Ltd. All rights re- served. 1089-9472/09/2404-0005$36.00/0 doi:10.1016/j.jopan.2009.03.013 Journal of PeriAnesthesia Nursing, Vol 24, No 4 (August), 2009: pp 233-240 233