Background. Most patients have moderate or severe pain after surgery. Opioids are the cornerstone of treating severe pain after surgery but cause problems when continued long after discharge. We investigated the efficacy of multifunction pain management software (MServ) in improving postoperative pain control and reducing opioid prescription at discharge. Methods. We recruited 234 patients to a prospective cohort study into sequential groups in a nonrandomised manner, one day after major thoracic or urological surgery. Group 1 received standard care (SC, n = 102), group 2 were given a multifunctional device that fed back to the nursing staff alone (DN, n = 66), and group 3 were given the same device that fed back to both the nursing staff and the acute pain team (DNPT, n = 66). Patient-reported pain scores at 24 and 48 hours and patient-reported time in severe pain, medications, and satisfaction were recorded on trial discharge. Findings. Odds of having poor pain control (>1 on 0–4 pain scale) were calculated between standard care (SC) and device groups (DN and DNPT). Patients with a device were significantly less likely to have poor pain control at 24 hours (OR 0.45, 95% CI 0.25, 0.81) and to report time in severe pain at 48 hours (OR 0.62, 95% CI 0.47–0.80). Patients with a device were three times less likely to be prescribed strong opioids on discharge (OR 0.35, 95% CI 0.13 to 0.95). Interpretation. Using an mHealth device designed for pain management, rather than standard care, reduced the incidence of poor pain control in the postoperative period and reduced opioid prescription on discharge from hospital.

中文翻译：

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交互式疼痛应用程序（MServ）改善术后疼痛管理

背景。大多数患者术后会出现中度或重度疼痛。阿片类药物是治疗术后严重疼痛的基石，但出院后持续很长时间会引起问题。我们研究了多功能疼痛管理软件（MServ）在改善术后疼痛控制和减少出院时阿片类药物处方方面的功效。方法。在大型胸腔或泌尿外科手术的第二天，我们以非随机的方式招募了234例患者，进行前瞻性队列研究。第一组接受标准护理（SC，n  = 102），第二组接受多功能设备，仅反馈给护理人员（DN，n = 66），第3组使用相同的装置反馈给护理人员和急性疼痛小组（DNPT，n  = 66）。试验出院时记录患者在24和48小时时报告的疼痛评分以及严重疼痛，药物治疗和满意度中患者报告的时间。调查结果。在标准护理（SC）和器械组（DN和DNPT）之间计算出疼痛控制不佳的可能性（在0–4疼痛评分上> 1）。使用器械的患者在24小时疼痛控制不佳的可能性显着降低（OR 0.45，95％CI 0.25，0.81），在48小时报告严重疼痛的时间（OR 0.62，95％CI 0.47–0.80）。使用器械的患者出院时处方强阿片类药物的可能性降低三倍（OR 0.35，95％CI 0.13至0.95）。解释。使用专为疼痛管理而非标准护理而设计的mHealth设备可减少术后疼痛控制不佳的发生率，并减少出院时的阿片类药物处方。