Prise en charge de la douleur postopératoire : l’étude AlgoSFAR, un audit national de 3315 patients

Introduction > The French Society of Anaesthesia and Intensive Care designed an online tool, AlgoSFAR, allowing anaesthesiologists to achieve an audit of their practice concerning postoperative pain. By analysing data collected from multiple centres, this study aimed to assess postoperative pain management in France and further suggest possible improvements. Patients and methods > In this multicentre observational trial, pre-, intra-and postoperative data collected during 2 years were analysed. The main outcome was postoperative pain. Secondary outcomes were: postoperative morphine consumption, evaluation of practices regarding multi modal analgesia. Results > Three thousand three hundred and fifteen patients from 70 centres were included. While 81% of the patients did not experience pain in PACU, only 6% had severe pain. Morphine requirements were low: only 23% received opioids either intraoperatively or in PACU (median 6 mg (IQR 4-9) of oral morphine equivalents). Combining intraoperative and PACU data, 67% and 49% of the patients received at least 2 or 3 non-opioid analgesics respectively. Thirty-two per cent of the patients who did not receive spinal or epidural opioids received morphine. The median total dose of morphine was 10 mg (IQR 6-30) from intraoperative period until discharge. Conclusion > Despite methodological limitations, our results showed that multimodal analgesia is widely used and efficient since patient experienced less pain consuming less opioids. These results highlight a great improvement in practices compared to the French national survey of 2008.