Evaluation of the effectiveness of pain management on the first day anterior rectal resections for malignant neoplasm

Abstract

Introduction. One of the most common malignancies is colorectal cancer, which in about 33% of cases it covers the rectum. Colorectal cancer is responsible for 10% of all cancers, and the observed trends indicate the dynamics of growth incidence of this type of cancer. The most common method of treating rectal cancer in the early stages is surgery. Pain is a symptom of both cancer and the consequences of surgical treatment, which is often an inseparable element. Therefore, in order to assess the effectiveness of postoperative pain relief, it is necessary to recognize their specificity and the type of activity undertaken by medical staff and patients.

Aim. The aim of the study was to assess the effectiveness of pain treatment in patients on the first day after anterior rectal resection due to a malignant neoplasm.

Material and methods. The research was carried out in the Oncology Center of Prof. Franciszek Łukaszczyk in Bydgoszcz, at the Clinical Department of General Oncology among 100 patients who were qualified for rectal surgery. The survey was anonymous and voluntary. The Polish version of the modified HADS-M scale was used for the study. A numerical scale - NRS was used to assess pain intensity. A questionnaire constructed by the author was also used. The method used was a diagnostic survey. The research technique was a questionnaire. As a research tool, a self-questionnaire was used, containing questions in the field of pain assessment. The survey also included information on the socio-demographic characteristics of the respondents. The obtained results were statistically analyzed by Pearson's chi-square test of independence, the assumed level of statistical significance is p < 0,05.

Results. Before surgery, most subjects felt mild pain at rest (47%), one hour after surgery most felt moderate pain (47%), 4 hours after surgery most felt mild pain (43%) and also 24 hours after surgery felt most mild pain (49%), but at the same time in 36% there was no pain at all. The Chi-square test showed a statistically significant increase in pain one hour postoperatively compared to preoperatively, and a statistically significant decrease in pain 4hours postoperatively compared to one hour postoperatively, and a statistically significant decrease in pain 24 hours postoperatively compared to 4 hours after the surgery. Slightly more than half of the respondents (58%) declare that the medicines they received completely relieved the pain. Based on the conducted research, it was found that as many as 4 out of 5 respondents (79%) declare that pain was most common in the area of the postoperative wound. Nearly half of the respondents (49%) believe that the pain after drain removal has decreased. The majority of respondents (72%) observed an increase in pain during ambulation after surgery. Most of the respondents characterized their pain as intermittent (27%) or stabbing (26%).

Conclusions: Patients feel significantly less pain after the treatment. After the procedure, they felt a reduction in pain. The most common complaints were in the area of the postoperative wound. Removal of the drain reduced the pain. Most often, patients felt periodic pain during actuation.