Postoperative pain management in Germany:: results of a survey

Objective. A survey was performed to obtain information on the organization and practice of postoperative pain management. Methods. A questionnaire was mailed to 773 directors of German departments of anesthesiology. Results. A total of 446 replies (57.7%) could be analyzed. Of the departments, 161 (36.1%) had established an acute pain service (APS), more often in hospitals 21000 beds (63%) than in hospitals with 400-999 beds (40%) and hospitals with <400 beds (27%). Epidural analgesia was practiced in 97% of the departments, however, it was the analgesic technique of choice for larger abdominal surgery or amputation of the lower limb only in 60.8% and 45.5% of the departments, respectively. Departments with APS provided epidural analgesia more often on general wards than departments without APS (88.2% vs.68.4%,p<0.01). Technically more challenging methods (e.g. catheters for regional anesthesia, PCA, PCEA) were more often provided in hospitals running an APS (p<0.001). Conclusions. The number of departments with APS has increased over the last 10 years. Future decisions on reimbursement should consider this extensive service.