749: Trends in Postoperative Pain Control and Acute Pain Service Referral: A 5-Year Retrospective Study

Topic: Education, Societal Impact, and Others
Subtopic: Organisation of clinical pain care

Background and Aims: Postoperative pain remains a significant clinical challenge, with a large proportion of surgical patients experiencing inadequate pain control. Acute Pain Services (APS) aim to optimize perioperative pain management through structured assessment and targeted interventions. However, local data describing APS utilization, referral patterns, and pain outcomes over time remain limited. This study aimed to describe trends in postoperative pain control, APS referral duration, and utilization in a tertiary hospital in the Philippines.

Methods: This retrospective descriptive study included postoperative patients referred to the APS from 2021 to 2025. Data collected included patient demographics, surgical subspecialty, pain scores categorized as none, mild, moderate, or severe (based on the numeric rating scale, critical care pain observation tool, FLACC scale, individualized according to the patient profile), duration of APS referral, and utilization of patient-controlled analgesia (PCA). Descriptive statistics were used to summarize findings and evaluate temporal trends over the 5-year period.

Results: APS referrals increased from 1,565 patients in 2021 to 2,163 in 2022, 2,343 in 2023, and remained high in 2024 (2,228) and 2025 (2,145), demonstrating sustained utilization in a high-volume surgical population. The majority of cases were consistently from general surgery and orthopedic subspecialties. The mean referral duration remained short and stable across years (2.21–2.69 days), with most patients referred for less than 2 days (range: ~45–53%). A smaller proportion required prolonged referral (>5 days) (~6–8%), representing more complex pain management cases. PCA utilization showed a declining trend over time (12.27% in 2021 to 5.46% in 2025), suggesting increasingly selective use of advanced analgesic modalities. Pain severity improved during APS care, with initial mild-to-severe pain observed across years (mild ~34–42%, moderate ~4–6%, severe ~1–3%). However, lowest pain scores were almost entirely “none” (~99–100%), and average pain scores were predominantly “none” (70–98%), indicating substantial reduction in pain severity.

Conclusions: This study demonstrates sustained and increasing utilization of APS in a tertiary hospital, with consistent patterns of early referral and short duration of involvement. Pain score trends indicate effective reduction in pain severity, while decreasing PCA utilization suggests more targeted and efficient analgesic strategies over time. These findings highlight the critical role of APS in optimizing postoperative pain management and support its continued integration into perioperative care systems, particularly in high-volume tertiary settings.

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Presenting Author: Angela Dawn A. Chacon
Submitting Author: Angela Chacon

Senior Author: Ma. Lourdes K. Cabaluna

IASP 2026 Global Year theme of Neuropathic Pain: No