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Bispebjerg Hospital - a part of Copenhagen University Hospital

Waking Up in Pain: a prospective unselected cohort study of pain in 3702 patients immediately after surgery in the Danish Realm

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  • Anders Mølgaard Rasmussen
  • Mette Helene Toft
  • Hussein Nasser Awada
  • Jesper Dirks
  • Birgitte Brandsborg
  • Line Kirkegaard Rasmussen
  • Ellen Kirkegaard
  • Dorthe Hasfeldt-Hansen
  • Thomas Egemose Larsen
  • Georgios Charalampidis
  • Emilie Louise Schjøtt Mørk
  • Chirstine Linaa Rosager
  • Idress Ahmad Salam
  • Bodil Steen Rasmussen
  • Marlene Jørgensen
  • Martin Skjønnemand
  • Caterina Amanti Lund
  • Save Schroder
  • Johan Kløvgaard Sørensen
  • Christoffer Sølling
  • Kristian Kraft Hansen
  • Christina Kirkegaard Rasmussen
  • Nick Phaff Steen
  • Anne Staal Nielsen
  • Anja Geisler
  • Kasper Storm Køppen
  • Maria Bolther Pælestik
  • Thorbjørn Grøfte
  • Christian Sylvest Meyhoff
  • Charlotte Loumann Kroh
  • Amalie Prien Christensen
  • Aleksander Fjeld Haugstvedt
  • Maria Aagaard Hansen
  • Christian Viggo Nielsen
  • Bitten Dybdal
  • Lars Falcon
  • Daniel Hägi-Pedersen
  • Kristian Jauho
  • Henrik Wolsted
  • Christian Alves Kohler Pedersen
  • Trine Nyboe Sommer
  • Laurits Schou Kromberg
  • Danja Lykke Kristensen
  • Camilla Kara Svensson
  • Hans Fjeldsøe Nielsen
  • Martin Kryspin Sørensen
  • Stig Jacobsen
  • Martin Sundskard
  • Nicole Brahe
  • Karina Jakobsen
  • Mette Skov Jensen
  • Lillian Odder
  • Hansjörg Selter
  • Tróndur Høgnason Mohr
  • Elin H Jensen
  • Pernille Pia Jensen
  • Christine Skjold
  • Eske Kvanner Aasvang
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BACKGROUND: Acute and persistent pain after surgery is well described. However, no large-scale studies on immediate postoperative pain in the operating room (OR) exist, hindering potential areas of research to improve clinical outcomes. Thus, we aimed to describe the occurrence and severity of immediate postoperative pain in a large, unselected cohort.

METHODS: This was a prospective cohort study, encompassing all procedures in 31 public hospitals in the Danish Realm, during a 5-day period including the weekend. Data on procedures and anesthesia were collected and the main outcome was occurrence of moderate or severe pain in the OR. Secondary outcomes included pain, sedation and nausea in the OR or during the first 15 min in the postanesthesia care unit (PACU) including relevant risk factors. Descriptive and logistic regression statistics were used.

RESULTS: A total of 3675 procedures were included for analysis (87% inclusion rate). Moderate or severe pain occurred in 7.4% (95% CI 6.5% to 8.3%) of cases in the OR immediately after awakening, rising to 20.2% in the OR and/or PACU. Large intraprocedure and interprocedure variations occurred (0.0%-37.5%), and in 20% of cases with epidural-general anesthesia patients experienced moderate or severe pain. Independent risk factors were female sex, younger age, preoperative pain, daily opioid use and major surgical procedures.

CONCLUSION: Moderate or severe pain in the immediate postoperative phase occurred in 20% of all cases with procedure and anesthesiological technique variations, suggesting a need for identification of relevant procedure-specific risk factors and development of preventive treatments.


Original languageEnglish
Article number102583
JournalRegional Anesthesia and Pain Medicine
Issue number11
Pages (from-to)948-953
Number of pages6
Publication statusPublished - Nov 2021

    Research areas

  • Analgesics, Opioid, Anesthesia, General, Cohort Studies, Denmark/epidemiology, Female, Humans, Pain, Postoperative/diagnosis, Prospective Studies

ID: 67149201