ASSESSMENT OF FACTORS AFFECTING ACUTE PAIN AND ITS PHARMACOLOGICAL CONTROL AFTER ELECTIVE SURGERIES IN A TERTIARY HOSPITAL IN PESHAWAR

Background: Post-surgical acute pain (POP) continues to be a critical concern in postoperative care, significantly affecting patient recovery, functional outcomes, and satisfaction. Despite advancements in analgesic strategies, a large proportion of patients still experience inadequately managed pain. Understanding the factors influencing POP and evaluating the effectiveness of pharmacological interventions is essential to optimize postoperative outcomes and reduce complications. Objective: To determine the prevalence and predictors of post-surgical acute pain and assess its pharmacological management among patients undergoing elective surgeries at a tertiary care hospital in Peshawar. Methods: A descriptive cross-sectional study was conducted over six months, enrolling 210 adult patients who underwent elective procedures under general or regional anesthesia. A pre-validated structured questionnaire was used to collect data on sociodemographic profiles, surgical details, pain characteristics using the Visual Analog Scale (VAS), analgesic regimens, effectiveness of pain relief, side effects, and patient satisfaction. Descriptive statistics, Chi-square tests, and binary logistic regression were applied using SPSS version 25 to identify associations and predictors, with significance set at p<0.05. Results: Among 210 patients, 123 (58.6%) were male and 71 (33.8%) had chronic illnesses. CABG was the most common procedure (47.1%), and general anesthesia was used in 86.7% of cases. POP was reported by 132 patients (62.9%), with 71 (33.8%) experiencing sharp pain and 67 (31.9%) dull pain. Pain impacted daily activities in 51% of cases. NSAIDs (36.7%) and paracetamol (31.9%) were the most prescribed analgesics, followed by opioids (20%) and combination therapy (11.4%). While 167 patients (79.5%) reported effective pain relief, 83 (39.5%) experienced side effects. Logistic regression identified chronic illness (OR = 2.12, p = 0.001), valve replacement surgery (OR = 1.72, p = 0.024), opioid use (OR = 2.51, p = 0.003), and combination therapy (OR = 3.01, p = 0.004) as significant predictors of POP. Conclusion: Postoperative pain is highly prevalent and influenced by comorbidities, type of surgery, and analgesic regimens. Adoption of individualized, multimodal pain management protocols and routine pain assessments is essential to enhance patient recovery and satisfaction.