THE ROLE OF SURGICAL GUIDANCE AND PSYCHOLOGICAL SUPPORT IN MANAGEMENT OF PAIN RELIEF AFTER THYROIDECTOMY

Aim: Inadequate management of postoperative pain is common since it has been neglected for too long. Our aim is to find out the effect of preoperative structured surgical information and psychological support that the patients received in pain relief after thyroidectomy. Methods: This prospective study has been conducted in Sohag University Hospitals, in the period from October 2007 to April 2009. Pain intensity was measured in day 1, 2, and 3 postoperatively in 132 patients undergoing thyroidectomy for simple multinodular goitre. They were divided into 4 groups: group (A) with no special surgical or anesthetic information or psychological preparation; group (B) with detailed surgical and anesthetic guidance; group (C) with psychological support; and group (D) with both surgical and anesthetic guidance and psychological support. The consumed analgesics were, also measured collectively in the postoperative three days and compared in the four groups of cases. All patients answered the questionnaire of 4-point scale for pain assessment. Results: Structured pre-surgical information and psychological preparation were negatively correlated with feeling of postoperative pain and this was statistically highly significant during day 1, 2, and 3 postoperatively (p 0.001; 0.001; 0.017 respectively). The mean consumed analgesic ampoules were more in group A than in group B and C and the least consumed analgesics was in group D and this was statistically highly significant (p 0.001). Conclusion: Systematic and structured preoperative surgical information and guidance provided by the surgeon, anesthesiologist, psychiatrist and nursing staff positively impacts the intensity of experienced postoperative pain and hence decreases the consumed analgesics and their side effects