Abstract
Introduction: Patients have been found to experience sub optimal pain management after cardiac surgery. The aim of this study was to investigate the patients' perceptions of the adequacy of pain management and factors affecting the site and intensity of pain experienced by cardiac surgical patients whilst in the critical care unit. The patients in this study were receiving a pain management regime, which consisted of intermittent pro re nata (prn) bolus doses of morphine Method: A non-experimental, descriptive and comparative study design was used. Data collected via interview related to demographics, analgesia administered, site of pain, severity of pain and level of satisfaction with the current pain management regime. A convenience sample of 102 patients was accessed. Most had coronary artery bypass graft surgery (CABGS) (75.5%) while some had CABGS and valve surgery (8.8%) or valve surgery alone (15.7%). Results: Analysis revealed that patients received limited amounts of morphine during their critical care stay (mean=26.7mg; SD: 13.3mg; range: 0-68mg). Patients with an internal mammary artery (IMA) graft and those younger than 65 years received significantly more morphine than did the other groups. The most common site of pain sensation was the chest wound area (91.2%). All activities were associated with increased pain. Females and patients with IMA grafts reported higher levels of pain. Conclusion: Overall, the majority of participants were reasonably satisfied with their pain experience. However, the following areas need improvement, the assessment and management of pain in relation to sex and age differences and the type of graft/s used and the administration of morphine prior to activity.