129 Development of a Post-Op Analgesic Regimen for Patients Undergoing Local Anaesthetic Hand Trauma Surgery

Abstract Aim Post-operative pain was a recurrent issue reported at the dressing clinic following local anaesthetic (LA) hand surgery at our regional centre. In the absence of a local protocol, we aimed to standardise advice and analgesic prescriptions following LA hand surgery to observe whether pain could be more optimally managed. Method In cycle 1, day 1 and 7 pain scores were recorded for ∼30 patients using a validated visual analogue scale (VAS). In cycle 2, an analgesia advice leaflet and standardised prescription were provided, and the same data points were collected, with the addition of day 0 (evening of surgery). Results Cycle 1 revealed generally high day 1 pain scores (M = 5.91/10). Day 7 scores were considered acceptable (M = 2.16). There was no significant difference in pain scores when we compared fracture fixation to soft tissue surgery (p= 0.64), and patients prescribed codeine versus those with paracetamol alone (p = 0.53). Most patients provided with codeine did not co-administer paracetamol and ibuprofen (n = 14, 70%). A large proportion of patients were only taking analgesia PRN rather than regularly for prophylaxis (n=12, 43.75%). In cycle 2, all patients were provided with codeine 30–60mg PRN QDS and the advice leaflet. Day 1 pain scores (3.43) were significantly lower for cycle 2 than cycle 1 (p < .00001). Conclusions Codeine, paracetamol and ibuprofen taken regularly and correctly can be effective in managing pain post-operatively for LA hand surgery patients. Information sheets can be an effective means of facilitating this.