Drug Utilization Pattern for Pain Management among Postoperative Patients of Orthopaedic and Surgery Departments in a Tertiary Care Hospital: A Prospective Observational Study
S. D. Akshay *
S. J. M College of Pharmacy, Chitradurga – 577502, Karnataka, India.
Abhijit Samai
S. J. M College of Pharmacy, Chitradurga – 577502, Karnataka, India.
Shreyas Gowda P.
S. J. M College of Pharmacy, Chitradurga – 577502, Karnataka, India.
V. S. Sowmya
Department of Pharmacy Practice, SJM College of Pharmacy, India.
Naveen Kumar S.
Department of Pharmacy Practice, SJM College of Pharmacy, India.
*Author to whom correspondence should be addressed.
Abstract
Aims: To evaluate analgesic utilisation patterns among postoperative patients in the Orthopaedic and Surgery departments of a tertiary care hospital; to compare opioid and non-opioid prescribing; to assess routes of administration and brand versus generic prescribing; and to compare the effectiveness of monotherapy and combination therapy.
Study Design: A Prospective observational study.
Place and Duration of Study: Departments of Orthopaedics and Surgery, Basaveshwara Medical College & Hospital, Chitradurga, Karnataka, India, over six months, from April 2025 to September 2025.
Methodology: Postoperative inpatients receiving analgesics were enrolled (n = 150). Demographic details, type of surgery, and analgesic drugs (class, dose, route, frequency, duration and brand/generic name) were recorded from case sheets and medication charts using a self-designed data collection form. Data were analysed using descriptive statistics and SPSS version 27. Pain reduction scores of monotherapy and combination therapy were compared using the Mann–Whitney U test.
Results: Of the 150 patients, 60% were male and 40% were female, with the largest group aged 31–45 years. Open reduction and internal fixation (13.16%) and appendectomy (12.50%) were the most common surgeries. Of 388 analgesic prescriptions analysed, non-opioids (57.11%) were most frequent, followed by opioids (17.57%) and adjuvants (13.95%). Paracetamol and diclofenac were the most prescribed non-opioids; tramadol was the predominant opioid. Intravenous administration (68.56%) was preferred over oral (31.44%). Brand-name prescribing (76.03%) exceeded generic prescribing (23.97%). Combination therapy achieved significantly greater pain reduction (mean score 3.59 ± 0.94) than monotherapy (2.87 ± 0.88; p < 0.001).
Conclusion: Combination therapy was associated with greater pain relief than monotherapy, supporting multimodal analgesia. Non-opioid analgesics formed the backbone of pain management, with tramadol the preferred opioid. However, the high prevalence of brand-name prescribing indicates a need to encourage generic prescribing for cost-effectiveness. Rational prescribing and multimodal strategies can improve patient outcomes and ensure safer postoperative pain management.
Keywords: Postoperative pain, analgesics, drug utilization pattern, multimodal analgesia, rational prescribing, orthopaedic and surgical patients