Anesthesia & Clinical Research
Open Access

Abstract

Incidence and Predictors of Moderate to Severe Post-Orthopedic Surgery Pain and Patients’ Satisfaction with Treatment in a Namibian Teaching Hospital: A Prospective Observational Study

Ambrose Rukewe*, Ivor Orlam, Abayomi Akeem Akande and Akinola Ayoola Fatiregun

Background: Orthopedic surgeries are synonymous with high pain scores, especially within the first 24 hours. Our objective was to determine the incidence and predictors of moderate to severe post-orthopedic surgery pain, investigate the influence of the type of anesthesia employed as well as evaluate patients’ satisfaction with treatment.

Methods: A prospective observational study was carried out on all patients 18 years and above, who had orthopedic surgeries between February and May 2023 under General Anesthesia (GA), Peripheral Nerve Block (PNB), Spinal Bupivacaine-Morphine (SpB-M) and Spinal Bupivacaine-Fentanyl (SpB-F). Pain was measured using the Numerical Rating Scale (NRS) in the Post-Anesthesia Care Unit (PACU), 4 h and 24 h. We defined NRS ≥ 4/10 as moderate to severe pain. Logistic regression was employed to identify predictors of moderate to severe pain.

Results: We studied 289 patients. The overall incidence of moderate to severe pain was 61%, in the PACU (17%), 4 h (36%) and 24 h (35%). The pain scores for PNB and SpB-M patients were significantly lower than GA patients in the PACU and 4 h (p=0.001). The mean time to first request for analgesics in the PNB patients was 602.6 ± 335 min versus 279.7 ± 293 for GA patients, p=0.001. GA was an independent predictor while SpB-M was significantly protective in the PACU and 4 h (P=0.020).

Conclusion: We found a low incidence of moderate to severe pain in the PACU while the overall incidence was comparable with other studies. GA was an independent predictor; SpB-M offered significant protection.

Published Date: 2026-01-26; Received Date: 2025-12-08