Skip to main content
bjmhr2@gmail.com
9409046853
e-ISSN: 2394-2967
British Journal of Medical and Health Research

British Journal of Medical and Health Research

Published

Prevalence and Temporal Pattern of Severe Postoperative Pain Among Adults Undergoing Major Orthopedic Surgery At A Tertiary Hospital In Kenya

Published in November 2026 Issue 11 (Vol. 13, Issue 11, 2026)

Prevalence and Temporal Pattern of Severe Postoperative Pain Among Adults Undergoing Major Orthopedic Surgery At A Tertiary Hospital In Kenya - Issue cover

Abstract

Pain, an unpleasant sensory and emotional experience associated with actual or potential tissue damage, is a significant global health concern, affecting orthopaedic patients in both developed and developing nations. Acute post-surgical pain is an important predictive factor of chronic postoperative pain. Inadequate pain management remains a prevalent issue for surgical patients, with estimates ranging from 20% to 80%. Locally, the growing number of patients presenting with chronic pain and poor rehabilitation post musculoskeletal surgery in orthopedic clinics is partly attributed to inadequately managed acute post-surgical pain. Consequently, assessing the prevalence of severe postoperative pain and the adequacy of analgesic prescriptions among musculoskeletal surgery patients is crucial. This research will assist orthopedic surgeons in developing effective post-surgical pain management protocols, potentially reducing the incidence of severe uncontrolled pain in wards and eventually chronic pain in the clinics. To establish the prevalence of severe post-surgical pain at Moi Teaching and Referral Hospital (MTRH), Eldoret, Kenya. This study is a hospital based prospective study based at MTRH theatre and orthopedic wards carried out between June, 2024 and December, 2024. A total of 320 patients scheduled for major orthopedic surgery who met the inclusion criteria were enrolled. Every fourth patient scheduled for orthopedic surgery was systematically sampled for assessment of post-surgical pain using numerical rating scale (NRS) Descriptive statistics were used for continuous variables and frequency and percentages for categorical data. The overall prevalence of severe post-surgical pain was 56.88% in the initial 72 hours. Severe pain was recorded at 37.19%, 23.44%, 27.19%, 10.31% and 6.25% in 2 hours, 12 hours, 24 hours, 48 hours and 72 hours respectively. Majority of the patients received multimodal analgesics at 57.81%. Prevalence of severe post-surgical pain in orthopedic patients was relatively high in the initial 72 hours. Introduction of pain assessment scales for regular assessment of pain scores in the initial 72 hours of surgery in orthopedic wards. Utilization of strong opioids and nerve blocks for control of post-surgical pain in the initial 72 hours. Keywords: Postoperative pain; severe pain; orthopedic surgery; pain prevalence; pain assessment

References

  1. [1]Aldanyowi SN. Novel techniques for musculoskeletal pain management after orthopedic surgical procedures: A systematic review. Life. 2023;13(12):2351.
  2. [2]Arefayne NR, Seid Tegegne S, Gebregzi AH, Mustofa SY. Incidence and associated factors of post-operative pain after emergency orthopedic surgery: A multi-centered prospective observational cohort study. International Journal of Surgery Open. 2020;27:103–113.
  3. [3]Armstrong AD, Hassenbein SE, Black S, Hollenbeak CS. Risk factors for increased postoperative pain and recommended orderset for postoperative analgesic usage. Clinical Journal of Pain. 2020;36(11):845–851.
  4. [4]Barbosa MH, Araújo NF de, Silva JAJ da, Corrêa TB, Moreira TM, Andrade ÉV. Pain assessment intensity and pain relief in patient's post-operative orthopedic surgery. Escola Anna Nery - Revista de Enfermagem. 2014;18(2):32–37.
  5. [5]Bayman EO, Parekh KR, Keech J, Larson N, Weg M Vander, Brennan TJ. Preoperative patient expectations of postoperative pain are associated with moderate to severe acute pain after VATS. Pain Medicine. 2019;20(3):543–554.
  6. [6]Bernstein LR. A pragmatic, general definition of pain. Pain Reports. 2020;5(2):e813.
  7. [7]Bérubé M, Choinière M, Laflamme YG, Gélinas C. Acute to chronic pain transition in extremity trauma: A narrative review for future preventive interventions (part 1). International Journal of Orthopaedic and Trauma Nursing. 2016;23:47–59.
  8. [8]Edgley C, Hogg M, De Silva A, Braat S, Bucknill A, Leslie K. Severe acute pain and persistent post-surgical pain in orthopaedic trauma patients: A cohort study. British Journal of Anaesthesia. 2019;123(3):350–359.
  9. [9]Ekstein MP, Weinbroum AA. Immediate postoperative pain in orthopedic patients is more intense and requires more analgesia than in post-laparotomy patients. Pain Medicine. 2011;12(2):308–313.
  10. [10]Fillingim RB. Individual differences in pain: Understanding the mosaic that makes pain personal. Pain. 2017;158(4):S11–S18.
  11. [11]Breivik H, Borchgrevink PC, Allen SM, Rosseland LA, Romundstad L, Breivik Hals EK, Kvarstein G, Stubhaug A. Assessment of pain. British Journal of Anaesthesia. 2008;101(1):103–106.
  12. [12]Chou R, Gordon DB, De Leon-Casasola OA, Rosenberg JM, Bickler S, Brennan T, et al. Management of postoperative pain: A clinical practice guideline from the American Pain Society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists' Committee on Regional Anesthesia, Executive Committee, and Administrative Council. Journal of Pain. 2016;17(2):131–157.
  13. [13]Wicaksono D, Herawati L, Sulistyono H. Pain level of postoperative orthopedic patients at Dr. Soetomo General Hospital. Indonesian Journal of Anesthesiology and Reanimation. 2019;1(1):19–25.
  14. [14]Mwashambwa MY, Yongolo IM, Kapalata SN, Meremo AJ. Post-operative pain prevalence, predictors, management practices and satisfaction among operated cases at a regional referral hospital in Dar es Salaam, Tanzania. Tanzania Journal of Health Research. 2018;20(2):1–8.
  15. [15]Ndebea AS, van den Heuvel SAS, Temu R, Kaino MM, van Boekel RLM, Steegers MAH. Prevalence and risk factors for acute postoperative pain after elective orthopedic and general surgery at a tertiary referral hospital in Tanzania. Journal of Pain Research. 2020;13:3005–3011.
  16. [16]Sharma BD, Sitaula J. Assessment of postoperative pain and analgesic use in patients undergoing orthopedic surgery. Journal of Chitwan Medical College. 2021;11(37):53–57.
  17. [17]Tsegaye D. Assessment of intraoperative and immediate postoperative pain management in adult orthopedic surgical patients at the Post Anesthesia Care Unit of Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia [dissertation]. Addis Ababa: Addis Ababa University College of Health Science, School of Medicine; 2017.
  18. [18]Nyambegera Zacharia Bosire B. Postoperative pain management after invasive lower limb orthopaedic surgery at Kenyatta National Hospital: A prospective study [thesis]. Nairobi: University of Nairobi; 2022.
  19. [19]Robleda G, Sillero-Sillero A, Puig T, Gich I, Baños JE. Influence of preoperative emotional state on postoperative pain following orthopedic and trauma surgery. Revista Latino-Americana de Enfermagem. 2014;22(5):785–791.
  20. [20]Gagliese L, Weizblit N, Ellis W, Chan VWS. The measurement of postoperative pain: A comparison of intensity scales in younger and older surgical patients. Pain. 2005;117(3):412–420.
  21. [21]Huang KTL, Owino C, Gramelspacher GP, Monahan PO, Tabbey R, Hagembe M, et al. Prevalence and correlates of pain and pain treatment in a Western Kenya referral hospital. Journal of Palliative Medicine. 2013;16(10):1260–1267.
  22. [22]Woldehaimanot TE, Eshetie TC, Kerie MW. Postoperative pain management among surgically treated patients in an Ethiopian hospital. PLoS ONE. 2014;9(7):1–9.
  23. [23]Eshete MT, Baeumler PI, Siebeck M, Tesfaye M, Haileamlak A, Michael GG, et al. Quality of postoperative pain management in Ethiopia: A prospective longitudinal study. PLoS ONE. 2019;14(5):1–22.
  24. [24]Getachew M, Lerdal A, Småstuen MC, Eshete MT, Desta T, Lindberg MF. Modifiable factors associated with a consistently high acute pain trajectory after surgical treatment of traumatic fractures in Ethiopia: A multi-center prospective cohort study. Journal of Orthopaedic Surgery and Research. 2023;18(1):451.
  25. [25]Hall JE, Guyton AC. Somatic sensation II: Pain, headache, and thermal sensations. In: Guyton and Hall Textbook of Medical Physiology. 13th ed. 2016. p. 621–623.
  26. [26]Heinricher MM. Pain modulation and the transition from acute to chronic pain. Advances in Experimental Medicine and Biology. 2016;904:105–115.

Authors (3)

Nyaboga A. Chrisantos

Department of Surgery and Anae...

View all publications →

Protus K. Werunga

Department of Orthopedics and ...

View all publications →

Barry R. Ayumba

Department of Surgery and Anae...

View all publications →

Download Article

PDF

Best for printing and citation

File size: 0.4 MB
Format: PDF

Summarise this paper with AI:

Article Information

BJMHR11130007

BJMHR-13-000073

93-103

2026-11-13

JATS XML

Article Impact

Views:1,666
Downloads:1,831

How to Cite

Chrisantos, N. A., Werunga, P. K., & Ayumba, B. R. (2026). Prevalence and Temporal Pattern of Severe Postoperative Pain Among Adults Undergoing Major Orthopedic Surgery At A Tertiary Hospital In Kenya. British Journal of Medical and Health Research, 13(11), 93-103. https://bjmhr.com/articles/BJMHR11130007

Article Actions

Whatsapp