Clinical aspects of acute post-operative pain management & its assessment

Anuj Gupta, Kirtipal Kaur, Sheeshpal Sharma, Shubham Goyal, Saahil Arora, R S R Murthy, Anuj Gupta, Kirtipal Kaur, Sheeshpal Sharma, Shubham Goyal, Saahil Arora, R S R Murthy

Abstract

Management of postoperative pain relieve suffering and leads to earlier mobilization, shortened hospital stay, reduced hospital costs, and increased patient satisfaction. An effective postoperative management is not a standardized regime rather is tailored to the needs of the individual patient, taking into account medical, psychological, and physical condition; age; level of fear or anxiety; surgical procedure; personal preference; and response to therapeutic agents given. The major goal in the management of postoperative pain is to minimize the dose of medications to lessen side effects & provide adequate analgesia. Postoperative pain is still under managed due to obstacles in implementation of Acute Pain Services due to insufficient education, fear of complications associated with available analgesic drugs, poor pain assessment and inadequate staff. This review reflects the clinical aspects of postoperative pain & its assessment & management with an emphasis on research for new analgesic molecules & delivery system.

Keywords: Post-operative pain management; assessment; clinical aspects.

Figures

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Fig. 1
Process of Nociception
Fig. 2
Fig. 2
Process of Central Sensitization
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Fig. 3
Normal Pathways of Pain
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Acute pain relief treatment chart
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Visual Analogue Scale
Fig. 6
Fig. 6
Numerical Pain Scale

References

    1. Sharrock N.E., Cazan M.G., Hargett M.J., Williams P.R., Wilson P.D. Changes in mortality after total hip and knee arthroplasty over a ten-year period. Anesth. Analg. 1995;80:242–248.
    1. Katz J, Jackson M., Kavanagh B.P., Sandler A.N. Acute pain after thoracic surgery predicts long-term post-thoracotomy pain. Clin. J. Pain. 1996;12:50–55.
    1. Mersky H. Pain terms: A list with definitions and notes on usage recommended by the IASP subcommittee on Taxonomy. Pain. 1979;6:249–252.
    1. Jorgen B.D., Kehlet H. Postoperative pain and its management. In: McMohan SB, Koltzenburg M, editors. Wall and Melzack's Textbook of pain. 5th ed. Philadelphia: Elsevier Churchill Livingstone; 2006.
    1. Parbrook G.D., Steel D.F., Dalrymple D.G. Factors predisposing to postoperative pain and pulmonary complications. Br. J. Anaesth. 1973;45:21–33.
    1. Szanto M.K., Heaman S. Postoperative demand analgesia. Surg. Gynaecol. Obs. 1972;134:647–51.
    1. Cousins M.J. Philadelphia: JB Lippincott, Inc.; 1988. Introduction to Acute and Chronic Pain: Neural Blockade in Clinical Anesthesia and Management of Pain.
    1. Fletcher D., Fermanian C., Mardaye A., Aegerter P. A patient-based national survey on postoperative pain management in France reveals significant achievements and persistent challenges. Pain. 2008;137:441–451.
    1. Atkinson T, Rushman G.B., Davies N. 11th ed. Oxford: Butterworth-Heinemann Ltd; 2007. Acute pain. In: Lee's synopsis of Anaesthesia.
    1. The College of Anaesthetists Commission for the Provision of Surgical Services. London: RCS; 1990. The Royal College of Surgeons (RCS) of England.
    1. Bekton F., Eken C., Karadenιz O., Goksu E., Cubuk M. Intravenous Paracetamol or Morphine for the Treatment of Renal Colic: A Randomized. Placebo-Controlled Trial. Annals of Emergency Medicine. 2009 Article in Press.
    1. Simon S.L., Grierson M.L., Naseer Z., Shainhouse Z.J. Efficacy and safety of topical diclofenac containing dimethyl sulfoxide (DMSO) compared with those of topical placebo DMSO vehicle and oral diclofenac for knee osteoarthritis. Pain. 2009;143:238–245.
    1. Jung T.K., Sherman O., Cuff G., Leibovits A. A double-blind prospective comparison of rofecoxib vs. ketorolac in reducing postoperative pain after arthroscopic knee surgery. J. Cli. Anes. 2005;17:439–433.
    1. Babul N., Noveck R., Chipman H., Roth S., Gana T., Albert T. Efficacy and safety of extended-release, once-daily tramadol in chronic pain: a randomized 12-week clinical trial in osteoarthritis of the knee. J. Pain & Symp. 2004;28:59–71.
    1. Harris S.N., Wenzel P.R., Thomas H.S. High altitude headache: Efficacy of Acetaminophen Vs Ibuprofen in a randomized, Controlled trial. J. Emer. Med. 2003;24:383–87.
    1. Walker J., Johnston J., Fairlie M.F., Lloyd J., Bullingham R. A comparative study of intramuscular ketorolac and pethidine in labour pain. Pain. 1992;46:87–94.

Source: PubMed

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