A research report submitted tot the Faculty of Health Sciences, University of the Witwatersrand , Johannesburg, in partial fulfillment of the requirements for the degree of Master of Medicine in the branch of Anaesthesia. Johannesburg, 2014 / Background: Post-operative pain is often undertreated, exposing patients to significant morbidity. The appropriate management of pain depends upon the accurate assessment thereof, however, this is difficult during general anaesthesia due to many confounders and thus intra-operative analgesia is administered according to multimodal “recipes” and changes in vital signs.
Aim: To determine whether intra-operative respiratory rate in a patient under general anaesthesia is a valid indicator of post-operative analgesic adequacy.
Method: The respiratory rates of 60 consenting adult female patients undergoing standardised general anaesthesia for elective breast surgery were measured. Post-operatively, each patient was assessed for the presence of pain using a Verbal Numeric Rating Scale (VNRS).
Results: Spearman correlation coefficient of 0.62 was calculated between the intra-operative respiratory rates and post-operative VNRS scores. A ROC curve (with AUC equals 0.77) was plotted to test the validity of respiratory rate as a predictor for post-operative pain, with a VNRS score greater than three indicating unacceptable pain. The suggested cut-off point for respiratory rate to predict unacceptable pain is greater than or equal to 17 breaths per minute.
Conclusion: The adequacy of post-operative analgesia may be predicted intra-operatively from the respiratory rate if patients are allowed to breathe spontaneously. This provides anaesthetists with a reliable, valid, affordable and easy method of titrating analgesia intra-operatively.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:wits/oai:wiredspace.wits.ac.za:10539/17356 |
| Date | 27 March 2015 |
| Creators | Jaworska, Magdalena Anna |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | application/pdf |
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