Abstract

Background: Numerous pain measurement scales have been evolved but not all have reliable outcome and cannot be used easily in all patients. The present study was done to assess the effect of literacy on ability to respond to the pain rating scales.

Materials & Methods: The present study was conducted in the department of anesthesiology in year 2015. It included 150 patients undergoing surgical procedures in surgery, obstetrics and gynecology, ENT, urology or neurosurgery. Intraoperative anaesthetic care was standardized to the type of the anaesthesia (general, spinal, blocks).  Patients were asked to rate their current pain intensity on VAS scale from 0 to 10 where 0 indicated no pain and 10 indicated the worst pain.

Similarly, for rating pain on the numeric analog scale, patients were asked to rate their current pain intensity on NAS scale from 0 to 100 where 0 indicated no pain and 100 indicated the worst pain. The pain rating was taken exactly 24 hours after completion of surgery.

Results: Out of 150 patients, males were 75 and females were 75. The difference was non- significant (P-1). Under general surgery, 45 patients responded to VAS while 12 not, O.B.G (35 responded, 10 not), orthopaedics ((35 responded, 6 not), others (20 responded, 7 not). Surgery < 30 minutes (12 responded, 3 not), 30mins – 2 hours (102 responded, 32 not), > 2hours (1 responded). Type of anaesthesia used was general anaesthesia (5 responded), spinal (40 responded, 20 not), epidural (30 responded, 5 not), local (25 responded, 5 not), block (15 responded, 5 not). Under general surgery, 45 patients responded to NAS while 11 not, O.B.G (45 responded, 12 not), orthopaedics (25 responded, 8 not), others (18 responded, 6 not). Surgery < 30 minutes (11 responded, 4 not), 30mins – 2 hours (100 responded, 31 not), > 2hours (2 responded, 2 not). Type of anaesthesia used was general anaesthesia (4 responded, 1 not), spinal (38 responded, 22 not), epidural (28 responded, 6 not), local (27 responded, 3 not), block (20 responded, 5 not). The difference was non- significant (P> 0.05).

Patients who responded to VAS were from upper (20), middle (80) and lower class (50). Those who responded to NAS were from upper (10), middle (70) and lower class (70). Their education level was primary (90), secondary (10) and illiterate (50) on VAS and primary (90), secondary (20) and illiterate (40) on NAS. The difference was significant (P< 0.05).

Conclusion: Numerous pain assessment scales are available, none are reliable. Visual analog scale and numeric analog scales are simple to perform tools for assessment of pain in Indian rural population, even illiterate patients can easily rate their pain on these scales.

Keywords: Numerical analog scale, Pain, Visual analog scale.