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Pain and Anxiety Experienced by Patients Following Placement of a Percutaneous Endoscopic Gastrostomy
Author(s) -
Oppong Philip,
Pitts Narrie,
Chudleigh Vicky,
Latchford Andrew,
Roy Amy,
Rocket Mark,
Lewis Stephen
Publication year - 2015
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1177/0148607114551798
Subject(s) - percutaneous endoscopic gastrostomy , medicine , gastrostomy , anxiety , enteral administration , percutaneous , anesthesia , parenteral nutrition , surgery , psychiatry , peg ratio , economics , finance
Background: Abdominal pain following percutaneous endoscopic gastrostomy (PEG) placement is a recognized complication. However, the prevalence and degree of severity of pain are poorly characterized. We assessed abdominal pain and anxiety levels associated with PEG placement in communicative and noncommunicative patients. Methods: A prospective questionnaire assessed patients' anxiety and abdominal pain 1 hour before, 1 hour after, and 24 hours after PEG placement using 11‐point Likert‐type scales. Patients were followed up until pain had resolved. Procedural data, analgesia requirements, and complications were recorded. For analysis, patients were divided into 2 groups: communicative (able to self‐assess) and noncommunicative (clinician assessed). Results: Seventy consecutive patients were assessed. Of the 49 self‐assessed patients, 11 (22%) reported immediate pain, 32 (65%) reported pain at 1 hour (24 mild, 5 moderate, 3 severe), and 40 (82%) reported pain at 24 hours. Pain most commonly lasted between 24 and 48 hours (25 patients). Of the 21 clinician‐assessed patients, only 1 was deemed to have pain, and this was at 24 hours. Four (6%) patients were admitted with pain. There was no relationship between preplacement anxiety scores and postplacement pain scores. Discussion: Abdominal pain after PEG placement pain is common but resolved by 48 hours in most patients. In patients able to communicate, clinicians scored pain lower compared with patients' scores. It is likely that pain is not identified in patients unable to communicate. Patients need to be better informed about the possibility of postprocedural pain and routinely offered access to appropriate analgesia.