Identification of patient, medical and nursing staff attitudes to postoperative opioid analgesia: stage 1 of a longitudinal study of postoperative analgesia.

Sixty-one successive patients undergoing routine cholecystectomy together with all the registered nursing staff and junior doctors working on the surgical wards in a major teaching hospital were studied by means of questionnaires. These were designed to identify beliefs and attitudes to postoperative analgesia in the hospital. The survey revealed that there is a continuing prevalence among medical and nursing staff of attitudes and practices likely to contribute to poor postoperative analgesia. Patients had low expectations of pain relief and displayed reluctance to request analgesia. Injections were generally effective when given, but dosing intervals were often too long for good analgesia. With this knowledge it has been possible to devise strategies to counteract those attitudes leading to poor analgesia and these have formed the basis of a new Acute Pain Service. It is intended to repeat this survey at 3 yearly intervals in order to monitor progress.