Title | Effect of a comfort scale compared with a pain numerical rate scale on opioids consumption in postanaesthesia care unit: the COMFORT study. |
Publication Type | Journal Article |
Year of Publication | 2024 |
Authors | Fusco N, Meuret L, Bernard F, Musellec H, Martin L, Léonard M, Lasocki S, Gazeau T, Aubertin R, Blayac D, Leviel F, Deserts MDanguy des, Madi-Jebara S, Fessler J, Lecoeur S, Cirenei C, Menut R, Lebreton C, Bouvier S, Bonnet C, Maurice-Szamburski A, Cattenoz M, Alami MEl, Brocas E, Aveline C, Gueguen L, Noll E, Gouel-Chéron A, Evrard O, Fontaine M, Nguyen Y-L, Ravry C, Boselli E, Laviolle B, Beloeil H |
Corporate Authors | COMFORT Study Group and the French Society of Anesthesiologists(SFAR) Research Network |
Journal | Br J Anaesth |
Volume | 133 |
Issue | 4 |
Pagination | 839-845 |
Date Published | 2024 Oct |
ISSN | 1471-6771 |
Keywords | Adult, Aged, Analgesics, Opioid, Anesthesia Recovery Period, Female, Humans, Length of Stay, Male, Middle Aged, Pain Measurement, Pain, Postoperative, Patient Satisfaction, Postoperative Nausea and Vomiting |
Abstract | BACKGROUND: The way that pain is assessed in the PACU could impact on postoperative pain and analgesic consumption. However, there is currently no evidence to support this speculation. The authors hypothesised that using a comfort scale reduces postoperative opioid consumption when compared with a standard numerical rating scale (NRS) to evaluate pain in the PACU. METHODS: In this cluster-randomised trial, patients were assessed using either a comfort scale (comfort group) or a pain NRS (NRS group). The primary outcome was the opioid consumption in the PACU. The main secondary outcomes were postoperative pain, nausea and vomiting, length of stay in the PACU, and satisfaction. RESULTS: Of 885 randomised patients, 860 were included in the analysis. Opioid consumption in the PACU was comparable in the comfort and NRS groups (median [interquartile range [IQR] 0 (0-5) vs 0 (0-6); P=0.2436), irrespective of the type of surgical procedure. The majority of patients did not need any postoperative opioid (59% in the comfort group and 56% in the NRS group, P=0.2260). There was no difference in postoperative pain, nausea and vomiting, time to reach an Aldrete score ≥9 after extubation, and global satisfaction. CONCLUSIONS: Using a comfort scale to assess pain in the PACU did not spare any opioid compared with use of a standard NRS. Further studies focusing on patients at risk of increased postoperative opioid consumption are necessary. CLINICAL TRIAL REGISTRATION: NCT05234216. |
DOI | 10.1016/j.bja.2024.06.029 |
Alternate Journal | Br J Anaesth |
PubMed ID | 39244480 |