Papers of the Week

: Postoperative pain management (POPM) appeared to be weak in Rwanda. : The aim of this study was to compare POPM measures in a teaching hospital between 2013 and 2017. : A two-phase observational study in 2013 and 2017. was conducted. Participants were recruited prior to major surgery and followed for two postoperative days. A numerical rating scale (0-10) was administered to all participants in both years, and the International Pain Outcomes questionnaire was administered in 2017. Recruitment, consent, and data collection were performed in participants' preferred language. : One hundred adult participants undergoing major general, gynecologic, orthopedic, or urologic surgery were recruited in 2013 and 83 were recruited in 2017. Fourteen percent of participants in 2013 and 46% in 2017 scored their worst pain as severe (>6; < 0.001). This was despite improved preoperative recognition of patients at high risk for severe postoperative pain (those with chronic pain or preoperative pain); 27% and 0% of these patients were not documented in 2013 and 2017, respectively ( = 0.006). Other measures of improved planning included "any preoperative discussion of POPM" ( < 0.001) and "discussion of POPM options" ( = 0.002). Preemptive analgesia use increased (3% of participants in 2013 and 54% in 2017; < 0.001). Incidence of participants having no postoperative analgesic at all decreased from 25% in 2013 to 5% in 2017 ( < 0.001). : Though severe postoperative pain incidence did not improve from 2013 to 2017, POPM improved by a number of measures. These changes may be attributed to pain research conducted there having raised awareness.