Review of the Current Situation of Postoperative Pain and Causes of Inadequate Pain Management in Africa

References

• Woldehaimanot TE, Eshetie TC, Kerie MW, Burney RE. Postoperative pain management among surgically treated patients in an Ethiopian hospital. PLoS One. 2014;9(7):e102835. doi:10.1371/journal.pone.0102835
   PubMed Web of Science ®Google Scholar
• Tano PF, Apiribu F, Tano EK, Boamah Mensah AB, Dzomeku VM, Boateng I. Predicting factors that determine patients’ satisfaction with post-operative pain management following abdominal surgeries at Komfo Anokye Teaching Hospital, Kumasi, Ghana. PLoS One. 2021;16(5):e0251979. doi:10.1371/journal.pone.0251979
   PubMed Web of Science ®Google Scholar
• Singh PK, Saikia P, Lahakar M. Prevalence of acute post operative pain in patients in adult age-group undergoing inpatient abdominal surgery and correlation of intensity of pain and satisfaction with analgesic management: across sectional single institute-based study. Indian J Anaesth. 2016;60(10):737–743. doi:10.4103/0019-5049.191686
   PubMedGoogle Scholar
• Tuchscherer J, McKay WP, Twagirumugabe T. Low-dose subcutaneous ketamine for postoperative pain management in Rwanda: a dose-finding study. Can J Anaesth. 2017;64(9):928–934. doi:10.1007/s12630-017-0914-0
   PubMed Web of Science ®Google Scholar
• Faponle AF, Soyannwo OA, Ajayi IO. Post operative pain therapy: a survey of prescribing patterns and adequacy of analgesia in Ibadan, Nigeria. Cent Afr J Med. 2001;47(3):70–74. doi:10.4314/cajm.v47i3.8597
   PubMedGoogle Scholar
• Johnson AP, Mahaffey R, Egan R, Twagirumugabe T, Parlow JL. Perspectives, perceptions and experiences in postoperative pain management in developing countries: a focus group study conducted in Rwanda. Pain Res Manag. 2015;20(5):255–260. doi:10.1155/2015/297384
   PubMed Web of Science ®Google Scholar
• Ndebea AS, van den Heuvel SAS, Temu R, Kaino MM, van Boekel RLM, Steegers MAH. Prevalence and risk factors for acute postoperative pain after elective orthopedic and general surgery at a tertiary referral hospital in Tanzania. J Pain Res. 2020;13:3005–3011. doi:10.2147/JPR.S258954
   PubMed Web of Science ®Google Scholar
• Mahama F, Ninnoni JPK. Assessment and management of postoperative pain among nurses at a resource constraint teaching hospital in Ghana. Nurs Res Pract. 2019;2019:9091467. doi:10.1155/2019/9091467
   PubMed Web of Science ®Google Scholar
• Kelley BP, Shauver MJ, Chung KC. Management of acute postoperative pain in hand surgery: a systematic review. J Hand Surg Am. 2015;40(8):1610–1619. doi:10.1016/j.jhsa.2015.05.024
   PubMed Web of Science ®Google Scholar
• Apfelbaum JL, Chen C, Mehta SS, Gan TJ. Postoperative pain experience: results from a national survey suggest postoperative pain continues to be under-managed. Anesth Analg. 2003;97(2):534–540. doi:10.1213/01.ANE.0000068822.10113.9E
   PubMed Web of Science ®Google Scholar
• Lovich-Sapola J, Smith CE, Brandt CP. Postoperative pain control. Surg Clin North Am. 2015;95(2):301–318. doi:10.1016/j.suc.2014.10.002
   PubMed Web of Science ®Google Scholar
• Mwaka G, Thikra S, Mung’ayi V. The prevalence of postoperative pain in the first 48 hours following day surgery at a tertiary hospital in Nairobi. Afr Health Sci. 2013;13(3):768–776. doi:10.4314/ahs.v13i3.36
   PubMed Web of Science ®Google Scholar
• Gan TJ. Poorly controlled postoperative pain: prevalence, consequences, and prevention. J Pain Res. 2017;10:2287–2298. doi:10.2147/JPR.S144066
   PubMed Web of Science ®Google Scholar
• Tola YO, Chow KM, Liang W. Effects of non-pharmacological interventions on preoperative anxiety and postoperative pain in patients undergoing breast cancer surgery: a systematic review. J Clin Nurs. 2021;30(23–24):3369–3384. doi:10.1111/jocn.15827
   PubMed Web of Science ®Google Scholar
• Wondemagegnehu BD, Tadess MM. Practice of postoperative pain management in under-five children in a tertiary hospital: a prospective crossectional study. Ethiop J Health Sci. 2022;32(6):1117–1122. doi:10.4314/ejhs.v32i6.8
   PubMed Web of Science ®Google Scholar
• Ayede AI. Neonatal pain management in sub-Saharan Africa. Lancet Child Adolesc Health. 2020;4(10):713–714. doi:10.1016/S2352-4642(20)30244-3
   PubMedGoogle Scholar
• Davis MP, Walsh D. Epidemiology of cancer pain and factors influencing poor pain control. Am J Hosp Palliat Care. 2004;21(2):137–142. doi:10.1177/104990910402100213
   PubMedGoogle Scholar
• Mabaso LMN, Bhettay A, Bandini R, Demopoulos D. A pediatric pain assessment and management survey at Rahima Moosa Mother and Child Hospital, Johannesburg, South Africa. S Afr Med J. 2022;112(8):539–541. doi:10.7196/SAMJ.v112i8.16271
   PubMed Web of Science ®Google Scholar
• Cardona CV, Rajah C, Mzoneli YN, et al. An audit of paediatric pain prevalence, intensity, and treatment at a South African tertiary hospital. Pain Rep. 2019;4(6):e789. doi:10.1097/PR9.0000000000000789
   PubMedGoogle Scholar
• Kalala B, Ferguson D, Nizeyimana F, et al. A survey of pediatric postoperative pain management in Rwanda. Can J Anaesth. 2021;68(11):1718–1720. doi:10.1007/s12630-021-02082-3
   PubMed Web of Science ®Google Scholar
• Boric K, Dosenovic S, Jelicic Kadic A, et al. Interventions for postoperative pain in children: an overview of systematic reviews. Paediatr Anaesth. 2017;27(9):893–904. doi:10.1111/pan.13203
   PubMed Web of Science ®Google Scholar
• Ogunyinka I, Yusuff K, Erah PO, et al. Community pharmacists’ knowledge and attitudes towards pediatric pain management in Nigeria. Risk Manag Healthc Policy. 2021;14:4595–4607. doi:10.2147/RMHP.S329387
   PubMed Web of Science ®Google Scholar
• Sama HD, Bang’na Maman AF, Djibril M, et al. Post-operative pain management in paediatric surgery at Sylvanus Olympio University Teaching Hospital, Togo. Afr J Paediatr Surg. 2014;11(2):162–165. doi:10.4103/0189-6725.132817
   PubMedGoogle Scholar
• Osifo OD, Aghahowa ES. Safety profile and efficacy of commonly used analgesics in surgical neonates in Benin City, Nigeria. Am J Perinatol. 2008;25(10):617–622. doi:10.1055/s-0028-1090582
   PubMed Web of Science ®Google Scholar
• Puchalski Ritchie LM, Howie SR, Njai PC. Development of a pain management protocol for a paediatric ward in the Gambia, West Africa. Int J Pediatr. 2010;2010:975313. doi:10.1155/2010/975313
   PubMedGoogle Scholar
• Madadi P, Enato EF, Fulga S, et al. Patterns of paediatric analgesic use in Africa: a systematic review. Arch Dis Child. 2012;97(12):1086–1091. doi:10.1136/archdischild-2012-302386
   PubMed Web of Science ®Google Scholar
• Vanden Bosch C, Cronje L, de Vasconcellos K, Skinner D. Pediatric postoperative analgesia prescribing report card: “could do better”. South Afr J Anesth Analges. 2019;25(4):30–36. doi:10.36303/SAJAA.2019.25.4.2257
   Web of Science ®Google Scholar
• Wall SL, Clarke DL, Nauhaus H, Allorto NL. Barriers to adequate analgesia in paediatric burns patients. S Afr Med J. 2020;110(10):1032–1035. doi:10.7196/SAMJ.2020.v110i10.14519
   PubMed Web of Science ®Google Scholar
• Booysen V, Burger JR, Du Plessis JM, Cockeran M. Assessment of post-operative pain medication adherence after day case orthopaedic surgery: a prospective, cross-sectional study. Int J Orthop Trauma Nurs. 2020;36:100718. doi:10.1016/j.ijotn.2019.100718
   PubMed Web of Science ®Google Scholar
• Coccolini F, Corradi F, Sartelli M, et al. Postoperative pain management in non-traumatic emergency general surgery: WSES-GAIS-SIAARTI-AAST guidelines. World J Emerg Surg. 2022;17(1):50. doi:10.1186/s13017-022-00455-7
   PubMed Web of Science ®Google Scholar
• Kaye AD, Armstead-Williams C, Hyatali F, et al. Exparel for postoperative pain management: a comprehensive review. Curr Pain Headache Rep. 2020;24(11):73. doi:10.1007/s11916-020-00905-4
   PubMed Web of Science ®Google Scholar
• Eshete MT, Baeumler PI, Siebeck M, et al. Quality of postoperative pain management in Ethiopia: a prospective longitudinal study. PLoS One. 2019;14(5):e0215563. doi:10.1371/journal.pone.0215563
   PubMed Web of Science ®Google Scholar
• Chou R, Gordon DB, De leon-casasola OA, et al. Management of postoperative pain: a clinical practice guideline from the American Pain Society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists’ Committee on Regional Anesthesia, Executive Committee, and Administrative Council. J Pain. 2016;17(2):131–157. doi:10.1016/j.jpain.2015.12.008
   PubMed Web of Science ®Google Scholar
• Kintu A, Abdulla S, Lubikire A, et al. Postoperative pain after cesarean section: assessment and management in a tertiary hospital in a low-income country. BMC Health Serv Res. 2019;19(1):68. doi:10.1186/s12913-019-3911-x
   PubMed Web of Science ®Google Scholar
• Masigati HG, Chilonga KS. Postoperative pain management outcomes among adults treated at a tertiary hospital in Moshi, Tanzania. Tanzan J Health Res. 2014;16(1):47–53. doi:10.4314/thrb.v16i1.7
   PubMedGoogle Scholar
• Munsaka EF, Van Dyk D, Parker R. A retrospective audit of pain assessment and management post-caesarean section at New Somerset Hospital in Cape Town, South Africa. S Afr Fam Pract. 2021;63(1):e1–e6. doi:10.4102/safp.v63i1.5320
   Web of Science ®Google Scholar
• Ching Wong SS, Cheung CW. Analgesic efficacy and adverse effects of meperidine in managing postoperative or labor pain: a narrative review of randomized controlled trials. Pain Physician. 2020;23(2):175–201. doi:10.36076/ppj.2020/23/175
   PubMed Web of Science ®Google Scholar
• Ekemen S, Yelken B, Ilhan H, Tokar B. A comparison of analgesic efficacy of tramadol and pethidine for management of postoperative pain in children: a randomized, controlled study. Pediatr Surg Int. 2008;24(6):695–698. doi:10.1007/s00383-008-2147-3
   PubMed Web of Science ®Google Scholar
• Hashemi SJ, Soltani H, Heidari SM, Rezakohanfekr M. Preemptive analgesia with intra-articular pethidine reduces pain after arthroscopic knee surgery. Adv Biomed Res. 2013;2:9. doi:10.4103/2277-9175.107971
   PubMedGoogle Scholar
• Jahromi SA, Valami SM, Yaghoubi S. Determining the effect of intraperitoneal pethidine on postoperative pain. Middle East J Anaesthesiol. 2011;21(1):39–42.
   PubMedGoogle Scholar
• Buli B, Gashaw A, Gebeyehu G, Abrar M, Gerbessa B. Patient satisfaction with post-operative pain management and associated factors among surgical patients at Tikur Anbessa Specialized Hospital: cross-sectional study. Ann Med Surg. 2022;79:104087. doi:10.1016/j.amsu.2022.104087
   PubMed Web of Science ®Google Scholar
• Cata JP, Corrales G, Speer B, Owusu-Agyemang P. Postoperative acute pain challenges in patients with cancer. Best Pract Res Clin Anaesthesiol. 2019;33(3):361–371. doi:10.1016/j.bpa.2019.07.018
   PubMed Web of Science ®Google Scholar
• Erden S, Arslan S, Deniz S, Kaya P, Gezer D. A review of postoperative pain assessment records of nurses. Appl Nurs Res. 2017;38:1–4. doi:10.1016/j.apnr.2017.08.003
   PubMed Web of Science ®Google Scholar
• Murray AA, Retief FW. Acute postoperative pain in 1 231 patients at a developing country referral hospital: incidence and risk factors. South Afr J Anaesth Analg. 2015;22(1):19–24. doi:10.1080/22201181.2015.1115608
   Google Scholar
• Khan MF, Omole OB, Marincowitz GJO. Postoperative analgesia following caesarean deliveries in a rural health district of South Africa. Trop Doct. 2009;39(4):217–221. doi:10.1258/td.2009.070497
   PubMed Web of Science ®Google Scholar
• Etoundi PO, Mbengono JAM, Ntock FN, et al. Knowledge, attitudes, and practices of Cameroonian physicians with regards to acute pain management in the emergency department: a multi-center cross-sectional study. BMC Emerg Med. 2019;19(1):45. doi:10.1186/s12873-019-0260-3
   PubMed Web of Science ®Google Scholar
• Nyirigira G, Wilson RA, VanDenKerkhof EG, et al. Barriers and facilitators to postoperative pain management in Rwanda from the perspective of healthcare providers: a contextualization of the theory of planned behavior. Can J Pain. 2018;2(1):87–102. doi:10.1080/24740527.2018.1451251
   PubMed Web of Science ®Google Scholar
• Kane O, Boua N, Hentchoya R, Seck M, Fall AN, Barry MS. Assessment of postoperative pain management practices in Cameroon, Ivory Coast and Senegal: a multi-national survey. Trop Doct. 2021;51(3):350–356. doi:10.1177/00494755211016115
   PubMed Web of Science ®Google Scholar
• Ally MA, Cloete E, Reed AR. A prospective clinical audit to evaluate postoperative quality of recovery in adults at New Somerset Hospital, Cape Town, South Africa. S Afr Med J. 2020;110(10):1036–1040. doi:10.7196/SAMJ.2020.v110i10.14693
   PubMed Web of Science ®Google Scholar
• Uwimana P, Mukamana D, Babenko-Mould Y, Adejumo O. Exploring factors affecting the facilitation of nursing students to learn pediatric pain management in Rwanda: a descriptive qualitative study. PLoS One. 2022;17(2):e0263609. doi:10.1371/journal.pone.0263609
   PubMed Web of Science ®Google Scholar
• Kizza IB, Muliira JK. Nurses’ pain assessment practices with critically ill adult patients. Int Nurs Rev. 2015;62(4):573–582. doi:10.1111/inr.12218
   PubMed Web of Science ®Google Scholar
• Albertyn R, Rode H, Millar AJ, Thomas J. Challenges associated with pediatric pain management in Sub Saharan Africa. Int J Surg. 2009;7(2):91–93. doi:10.1016/j.ijsu.2009.01.005
   PubMed Web of Science ®Google Scholar
• Eyelade OR, Oladokun RE, Fatiregun AA. Convergent validity of pain measuring tools among Nigerian children. Afr J Med Med Sci. 2009;38(4):333–336. doi:10.1080/22201181.2015.1115608
   PubMedGoogle Scholar
• Young JR, Sih C, Hogg MM, Anderson-Montoya BL, Fasano HT. Qualitative assessment of face validity and cross-cultural acceptability of the faces pain scale: “Revised” in Cameroon. Qual Health Res. 2018;28(5):832–843. doi:10.1177/1049732318757488
   PubMed Web of Science ®Google Scholar
• Tomlinson D, von Baeyer CL, Stinson JN, Sung L. A systematic review of faces scales for the self-report of pain intensity in children. Pediatrics. 2010;126(5):e1168–e1198. doi:10.1542/peds.2010-1609
   PubMed Web of Science ®Google Scholar
• Kusi Amponsah A, Kyei EF, Agyemang JB, et al. Nursing-related barriers to children’s pain management at selected hospitals in Ghana: a descriptive qualitative study. Pain Res Manag. 2020;2020:7125060. doi:10.1155/2020/7125060
   PubMed Web of Science ®Google Scholar
• Kusi Amponsah A, Oduro E, Bam V, Kyei-Dompim J, Ahoto CK, Axelin A. Dynamics on the field: a focused study on the culture and context of pediatric pain management at four Ghanaian hospitals. BMC Pediatr. 2020;20(1):529. doi:10.1186/s12887-020-02399-w
   PubMed Web of Science ®Google Scholar
• Anim-Boamah O, Aziato L, Adabayeri VM. Ghanaian nurses’ knowledge of invasive procedural pain and its effect on children, parents and nurses. Nurs Child Young People. 2017;29(7):26–31. doi:10.7748/ncyp.2017.e795
   PubMedGoogle Scholar
• Wuni A, Salia SM, Mohammed Ibrahim M, et al. Evaluating knowledge, practices, and barriers of pediatric pain management among nurses in a tertiary health facility in the Northern Region of Ghana: a descriptive cross-sectional study. Pain Res Manag. 2020;2020:8846599. doi:10.1155/2020/8846599
   PubMed Web of Science ®Google Scholar
• Adenekan AT, Owojuyigbe AM, Aaron OI, et al. Impact of pain management workshop on the knowledge and attitude of healthcare workers and opioid utilization in a Nigerian Teaching Hospital. West Afr J Med. 2019;36(3):232–238.
   PubMedGoogle Scholar
• Liyew B, Dejen Tilahun A, Habtie Bayu N, Kassew T. Knowledge and attitude towards pain management among nurses working at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. Pain Res Manag. 2020;2020:6036575. doi:10.1155/2020/6036575
   PubMed Web of Science ®Google Scholar
• Menlah A, Garti I, Amoo SA, Atakro CA, Amponsah C, Agyare DF. Knowledge, Attitudes, and Practices of Postoperative Pain Management by Nurses in Selected District Hospitals in Ghana. SAGE Open Nurs. 2018;4:2377960818790383. doi:10.1177/2377960818790383
   Web of Science ®Google Scholar
• Aziato L, Adejumo O. Determinants of nurses’ knowledge gap on pain management in Ghana. Nurse Educ Pract. 2014;14(2):195–199. doi:10.1016/j.nepr.2013.08.004
   PubMed Web of Science ®Google Scholar
• Aleku M, Nelson K, Abio A, Lowery Wilson M, Lule H. Lower back pain as an occupational hazard among Ugandan health workers. Front Public Health. 2021;9:761765. doi:10.3389/fpubh.2021.761765
   PubMed Web of Science ®Google Scholar
• Kidanemariam BY, Elsholz T, Simel LL, Tesfamariam EH, Andemeskel YM. Utilization of non-pharmacological methods and the perceived barriers for adult postoperative pain management by the nurses at selected National Hospitals in Asmara, Eritrea. BMC Nurs. 2020;19:100. doi:10.1186/s12912-020-00492-0
   PubMed Web of Science ®Google Scholar
• Odejobi YO, Maneewat K, Chittithavorn V. Nurse-led post-thoracic surgery pain management programme: its outcomes in a Nigerian Hospital. Int Nurs Rev. 2019;66(3):434–441. doi:10.1111/inr.12515
   PubMed Web of Science ®Google Scholar
• Nortjé N, Albertyn R. The cultural language of pain: a South African study. South Afr Fam Pract. 2015;57(1):24–27. doi:10.1080/20786190.2014.977034
   Web of Science ®Google Scholar
• Ness SM. Pain expression in the perioperative period: insights from a focus group of Somali women. Pain Manag Nurs. 2009;10(2):65–75. doi:10.1016/j.pmn.2008.05.001
   PubMed Web of Science ®Google Scholar
• Onsongo LN. Barriers to cancer pain management among nurses in Kenya: a focused ethnography. Pain Manag Nurs. 2020;21(3):283–289. doi:10.1016/j.pmn.2019.08.006
   PubMed Web of Science ®Google Scholar
• Mphahlele N, Mitchell D, Kamerman P. Validation of the Wisconsin Brief Pain Questionnaire in a multilingual South African population. J Pain Symptom Manage. 2008;36(4):396–412. doi:10.1016/j.jpainsymman.2007.10.020
   PubMed Web of Science ®Google Scholar
• Olaogun A, Ayandiran O, Olalumade O, Obiajunwa P, Adeyemo F. Knowledge and management of infants’ pain by mothers in Ile Ife, Nigeria. Int J Nurs Pract. 2008;14(4):273–278. doi:10.1111/j.1440-172X.2008.00693.x
   PubMed Web of Science ®Google Scholar
• Nasir M, Ahmed A. Knowledge about postoperative pain and its management in surgical patients. Cureus. 2020;12(1):e6685. doi:10.7759/cureus.6685
   PubMed Web of Science ®Google Scholar
• Rawal N. Current issues in postoperative pain management. Eur J Anaesthesiol. 2016;33(3):160–171. doi:10.1097/EJA.0000000000000366
   PubMed Web of Science ®Google Scholar
• Sun VC, Borneman T, Ferrell B, Piper B, Koczywas M, Choi K. Overcoming barriers to cancer pain management: an institutional change model. J Pain Symptom Manage. 2007;34(4):359–369. doi:10.1016/j.jpainsymman.2006.12.011
   PubMed Web of Science ®Google Scholar
• Glajchen M. Chronic pain: treatment barriers and strategies for clinical practice. J Am Board Fam Pract. 2001;14(3):211–218.
   PubMedGoogle Scholar
• Ward S, Hughes S, Donovan H, Serlin RC. Patient education in pain control. Support Care Cancer. 2001;9(3):148–155. doi:10.1007/s005200000176
   PubMed Web of Science ®Google Scholar
• Aziato L, Adejumo O. The Ghanaian surgical nurse and postoperative pain management: a clinical ethnographic insight. Pain Manag Nurs. 2014;15(1):265–272. doi:10.1016/j.pmn.2012.10.002
   PubMed Web of Science ®Google Scholar
• Noble M, Treadwell JR, Tregear SJ, et al. Long-term opioid management for chronic noncancer pain. Cochrane Database Syst Rev. 2010;2010(1):CD006605. doi:10.1002/14651858.CD006605.pub2
   PubMedGoogle Scholar
• Bosnjak S, Maurer MA, Ryan KM, Leon MX, Madiye G. Improving the availability and accessibility of opioids for the treatment of pain: the International Pain Policy Fellowship. Support Care Cancer. 2011;19(8):1239–1247. doi:10.1007/s00520-011-1200-2
   PubMed Web of Science ®Google Scholar
• Ohene-Yeboah M. Acute surgical admissions for abdominal pain in adults in Kumasi, Ghana. ANZ J Surg. 2006;76(10):898–903. doi:10.1111/j.1445-2197.2006.03905.x
   PubMed Web of Science ®Google Scholar
• Cheelo M, Brugha R, Bijlmakers L, Kachimba J, McCauley T, Gajewski J. Surgical capacity at district hospitals in Zambia: from 2012 to 2016. World J Surg. 2018;42(11):3508–3513. doi:10.1007/s00268-018-4678-7
   PubMed Web of Science ®Google Scholar
• Dell AJ, Kahn D. Surgical resources in South Africa: an international comparison and deficit calculation. World J Surg. 2018;42(2):541–548. doi:10.1007/s00268-017-4176-3
   PubMed Web of Science ®Google Scholar
• Anesi GL, Gabler NB, Allorto NL, et al. Intensive care unit capacity strain and outcomes of critical illness in a resource-limited setting: a 2-hospital study in South Africa. J Intensive Care Med. 2020;35(10):1104–1111. doi:10.1177/0885066618815804
   PubMed Web of Science ®Google Scholar
• Onyeka TC, Chukwuneke FN. Pain research in Africa: a ten-year bibliometric survey. J Anesth. 2014;28(4):511–516. doi:10.1007/s00540-013-1767-5
   PubMed Web of Science ®Google Scholar
• Chao TE, Burdic M, Ganjawalla K, et al. Survey of surgery and anesthesia infrastructure in Ethiopia. World J Surg. 2012;36(11):2545–2553. doi:10.1007/s00268-012-1729-3
   PubMed Web of Science ®Google Scholar
• Menkiti ID, Desalu I, Kushimo OT. Low-dose intravenous ketamine improves postoperative analgesia after caesarean delivery with spinal bupivacaine in African parturients. Int J Obstet Anesth. 2012;21(3):217–221. doi:10.1016/j.ijoa.2012.04.004
   PubMed Web of Science ®Google Scholar
• Zewdu D, Tantu T, Olana M, Teshome D. Effectiveness of wound site infiltration for parturients undergoing elective cesarean section in an Ethiopian hospital: a prospective cohort study. Ann Med Surg. 2021;64:102255. doi:10.1016/j.amsu.2021.102255
   PubMed Web of Science ®Google Scholar
• Umutesi G, McEvoy MD, Starnes JR, et al. Safe anesthesia care in Western Kenya: a preliminary assessment of the impact of nurse anesthetists at multiple levels of government hospitals. Anesth Analg. 2019;129(5):1387–1393. doi:10.1213/ANE.0000000000004266
   PubMed Web of Science ®Google Scholar
• Suarez S, Burke TF, Yusufali T, Makin J, Sessler DI. The role of ketamine in addressing the anesthesia gap in low-resource settings. J Clin Anesth. 2018;49:42–43. doi:10.1016/j.jclinane.2018.06.009
   PubMed Web of Science ®Google Scholar
• Purcell LN, Robinson B, Msosa V, Gallaher J, Charles A. District general hospital surgical capacity and mortality trends in patients with acute abdomen in Malawi. World J Surg. 2020;44(7):2108–2115. doi:10.1007/s00268-020-05468-4
   PubMed Web of Science ®Google Scholar
• Law TJ, Bulamba F, Ochieng JP, et al. Anesthesia provider training and practice models: a survey of Africa. Anesth Analg. 2019;129(3):839–846. doi:10.1213/ANE.0000000000004302
   PubMed Web of Science ®Google Scholar
• Alsirafy SA, Farag DE. A shortage of oral morphine in Egypt. Bull World Health Organ. 2016;94(1):3. doi:10.2471/BLT.15.156240
   PubMed Web of Science ®Google Scholar
• Soyannwo O. Pain management in sub-Saharan Africa: innovative approaches to improving access. Pain Manag. 2014;4(1):5–7. doi:10.2217/pmt.13.68
   PubMedGoogle Scholar
• O’Brien M, Schwartz A, Plattner L. Treat the Pain Program. J Pain Symptom Manage. 2018;55(2S):S135–S139. doi:10.1016/j.jpainsymman.2017.03.033
   PubMedGoogle Scholar
• Furlan AD, Harvey AM, Chadha R. Warning from Canada: latin America, South Africa and India may face an opioid epidemic in the coming years. J Glob Health. 2020;10(1):010324. doi:10.7189/jogh.10.010324
   PubMed Web of Science ®Google Scholar
• Swarm RA, Dans M. NCCN frameworks for resource stratification of NCCN guidelines: adult cancer pain and palliative care. J Natl Compr Canc Netw. 2018;16(5S):628–631. doi:10.6004/jnccn.2018.0044
   PubMed Web of Science ®Google Scholar
• Usman MA. Opioid Crisis: the African Perspective. Disaster Med Public Health Prep. 2022;16(1):3–4. doi:10.1017/dmp.2020.259
   PubMed Web of Science ®Google Scholar
• Namisango E, Allsop MJ, Powell RA, et al. Investigation of the practices, legislation, supply Chain, and regulation of opioids for clinical pain management in Southern Africa: a multi-sectoral, cross-national, mixed methods study. J Pain Symptom Manage. 2018;55(3):851–863. doi:10.1016/j.jpainsymman.2017.11.010
   PubMed Web of Science ®Google Scholar
• Onwuchekwa Uba R, Ankoma-Darko K, Park SK. International comparison of mitigation strategies for addressing opioid misuse: a systematic review. J Am Pharm Assoc. 2020;60(1):195–204. doi:10.1016/j.japh.2019.09.002
   Google Scholar
• Harker N, Lucas WC, Laubscher R, Dada S, Myers B, Parry CD. Is South Africa being spared the global opioid crisis? A review of trends in drug treatment demand for heroin, nyaope and codeine-related medicines in South Africa (2012–2017). Int J Drug Policy. 2020;83:102839. doi:10.1016/j.drugpo.2020.102839
   PubMed Web of Science ®Google Scholar
• Cleary J, Simha N, Panieri A, et al. Formulary availability and regulatory barriers to accessibility of opioids for cancer pain in India: a report from the Global Opioid Policy Initiative (GOPI). Ann Oncol. 2013;24(Suppl 11):xi33–xi40. doi:10.1093/annonc/mdt501
   PubMedGoogle Scholar
• Yorke E, Oyebola FO, Otene SA, Klein A. Tramadol: a valuable treatment for pain in Ghana and Nigeria. Curr Med Res Opin. 2019;35(5):777–784. doi:10.1080/03007995.2019.1585168
   PubMed Web of Science ®Google Scholar
• Darweesh FF, Samy A, Mousa AM, et al. Role of oral tramadol 50 mg in reducing pain during colposcopy-directed cervical biopsy: a randomized controlled trial. J Low Genit Tract Dis. 2020;24(2):206–210. doi:10.1097/LGT.0000000000000522
   PubMed Web of Science ®Google Scholar
• Fynn A, Helberg E, Godman B, Meyer JC. Drug utilization review of tramadol hydrochloride in a regional hospital in South Africa; findings and implications. Hosp Pract. 2020;48(2):92–99. doi:10.1080/21548331.2020.1724454
   PubMedGoogle Scholar
• Klein A, Patwardhan S, Loglo MGA. Divergences and commonalities between the US opioid crisis and prescription medicine misuse in West Africa. Int J Drug Policy. 2020;76:102640. doi:10.1016/j.drugpo.2019.102640
   PubMed Web of Science ®Google Scholar
• Samuel H, Aweke S, Tuni J. Effect of low-dose intravenous ketamine on postoperative pain following cesarean section under spinal anesthesia: a prospective cohort study, Ethiopia. Ann Med Surg. 2022;77:103570. doi:10.1016/j.amsu.2022.103570
   PubMed Web of Science ®Google Scholar
• Zakine J, Samarcq D, Lorne E, et al. Postoperative ketamine administration decreases morphine consumption in major abdominal surgery: a prospective, randomized, double-blind, controlled study. Anesth Analg. 2008;106(6):1856–1861. doi:10.1213/ane.0b013e3181732776
   PubMed Web of Science ®Google Scholar
• Dahmani S, Michelet D, Abback PS, et al. Ketamine for perioperative pain management in children: a meta-analysis of published studies. Paediatr Anaesth. 2011;21(6):636–652. doi:10.1111/j.1460-9592.2011.03566.x
   PubMed Web of Science ®Google Scholar
• Sacevich C, Semakuba B, McKay WP, Thakore S, Twagirumugabe T, Nyiligira J. Subcutaneous ketamine for postoperative pain relief in Rwanda: a randomized clinical trial. Can J Anaesth. 2018;65(2):170–177. doi:10.1007/s12630-017-1009-7
   PubMed Web of Science ®Google Scholar
• Wall S, Bangalee V. The ketamine crisis: does South Africa have a plan B? S Afr Med J. 2019;109(12):911–913. doi:10.7196/SAMJ.2019.v109i12.14188
   PubMed Web of Science ®Google Scholar
• Rusakaniko S, Makanga M, Ota MO, et al. Strengthening national health research systems in the WHO African Region - progress towards universal health coverage. Global Health. 2019;15(1):50. doi:10.1186/s12992-019-0492-8
   PubMedGoogle Scholar
• Onyeka TC, Iloanusi N, Namisango E, et al. Project OPUS: development and evaluation of an electronic platform for pain management education of medical undergraduates in resource-limited settings. PLoS One. 2020;15(12):e0243573. doi:10.1371/journal.pone.0243573
   PubMed Web of Science ®Google Scholar