Understanding Interventional Pain Management: A Guide to Techniques and Applications for the Terminally Ill Patient With Severe Pain (SA523)

Pain management is an integral challenge in nursing and includes the responsibility of managing patients’ pain, evaluating pain therapy and ensuring the quality of care. The aims of this study were to explore patients’ experiences of pain after lung surgery and evaluate their satisfaction with the postoperative pain management. A descriptive design was used which studied 51 participants undergoing lung surgery. The incidence of moderate postoperative pain varied from 36- 58% among the participants and severe pain from 11-26%, during their hospital stay. Thirty-nine percent had more pain than expected. After three months, 20% experienced moderate pain and 4% experienced severe pain, while after six months, 16% experienced moderate pain. The desired quality of care goal was not fully achieved. We conclude that a large number of patients experienced moderate and severe postoperative pain and more than one third had more pain than expected. However, 88% were satisfied with the pain management. The findings confirm the severity of pain experienced after lung surgery and facilitate the apparent need for the continued improvement of postoperative pain management following this procedure.

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COVID-19 lockdown and its impact on cancer pain management: A telephone survey of terminally ill patients

Palliative Medicine ◽

10.1177/02692163211011351 ◽

2021 ◽

pp. 026921632110113

Author(s):

Abhinav Prakash ◽

Nishant Sahay ◽

Umesh Kumar Bhadani ◽

Shagufta Naaz ◽

Rajnish Kumar ◽

...

Keyword(s):

Pain Management ◽

Cancer Pain ◽

Telephone Survey ◽

Terminally Ill ◽

Cancer Pain Management ◽

Terminally Ill Patients

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An Audit of Pain Control Pathways following Video-Assisted Thoracoscopic Surgery

Innovations Technology and Techniques in Cardiothoracic and Vascular Surgery ◽

10.1097/imi.0b013e31822b2cc1 ◽

2011 ◽

Vol 6 (4) ◽

pp. 248-252 ◽

Cited By ~ 5

Author(s):

Espeed Khoshbin ◽

Ali N. Al-Jilaihawi ◽

Nicholas B. Scott ◽

Dhruva Prakash ◽

Alan J. B. Kirk

Keyword(s):

Pain Management ◽

Pain Relief ◽

Visual Analog Scale ◽

Severe Pain ◽

Thoracoscopic Surgery ◽

Analog Scale ◽

Pain Scores ◽

Audit Commission ◽

Video Assisted Thoracoscopic Surgery ◽

Daily Pain

Objective To compare different modes of pain management following video-assisted thoracoscopic surgery (VATS) to our national standard. Methods This is an audit based on patient's experiences. One hundred consecutive patients who underwent VATS with or without pleurodesis were managed by one of the following pain relief pathways: (A) thoracic paravertebral block + morphine patient-controlled analgesia (PCA), (B) percutaneous thoracic paravertebral catheter +/– morphine PCA, (C) thoracic epidural +/– morphine PCA, (D) morphine PCA alone, and (E) intravenous or subcutaneous morphine as required. Pain score was documented up to four times per day for each patient. The incidence of severe pain was defined as visual analog scale ≥7. The results were compared with the standard set by the audit commission for postoperative pain relief in the UK. The mean daily pain scores were calculated retrospectively for all patients. Results There were no statistically significant differences in mean daily pain scores irrespective of having a pleurodesis. The percentage of patients experiencing severe pain was 34% [mean visual analog scale = 8 (standard deviation = 1.0)]. This was almost seven times the standard. Among these pathways, B had the least percentage incidence of severe pain (16.7%) followed by A (25.0%) D (33.3%), C (35.7%), and E (52.4%). Conclusions We are not compliant with the standards set by the audit commission. Pain management in theater recovery needs to be targeted. In the light of these results, we recommend the use of percutaneous thoracic paravertebral catheter +/– morphine PCA for postoperative VATS pain relief.

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Is Ultrasound Guidance Advantageous for Interventional Pain Management? A Systematic Review of Chronic Pain Outcomes

Anesthesia & Analgesia ◽

10.1213/ane.0b013e31828f5ee4 ◽

2013 ◽

Vol 117 (1) ◽

pp. 236-251 ◽

Cited By ~ 26

Author(s):

Anuj Bhatia ◽

Richard Brull

Keyword(s):

Systematic Review ◽

Chronic Pain ◽

Pain Management ◽

Ultrasound Guidance ◽

Pain Outcomes ◽

Interventional Pain Management

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Multimodal Analgesia in Perioperative Settings: Improvement Perspectives / Multimodāla Analgēzija Perioperatīvajā Periodā: Uzlabošanas Iespējas

Proceedings of the Latvian Academy of Sciences Section B Natural Exact and Applied Sciences ◽

10.2478/prolas-2014-0027 ◽

2014 ◽

Vol 68 (5-6) ◽

pp. 222-227

Author(s):

Iveta Golubovska ◽

Aleksejs Miščuks ◽

Ēriks Rudzītis

Keyword(s):

Pain Management ◽

Lower Extremity ◽

Pain Intensity ◽

Severe Pain ◽

Rating Scale ◽

Multimodal Analgesia ◽

Numeric Rating Scale ◽

Plexus Brachialis ◽

Single Shot ◽

Maximum Pain

Abstract The aim of this study was to evaluate the intensity of pain in orthopaedic hospital patients and to identify unsatisfactory pain management and possibilities for improvements in the future. Data collection included Numeric Rating Scale (NRS) scores, which characterised the intensity of pain. Maximum pain on the day of surgery, mean pain on the day of surgery (D0), and mean pain on first (D1) and second (D2) postoperative days were documented. The pain of an intensity from 0 to 3 was defined as mild pain, 4 to 6 as moderate pain, and 6 to 10 as severe pain. Maximum severe pain intensity on the day of surgery was experienced by 20.5% of patients, moderate by 45.8%, and mild by 33.6%. The reported mean pain intensity according to type of surgery was as follows: hip replacement- 2.79 ± 1.6 (D0), 2.09 ± 1.4 (D1), and 1.35 ± 1.2 (D2); knee replacement - 3.39 ± 1.7 (D0), 2.98 ± (D1), 1.82 ± 1.36, and (D2); upper extremity surgery - 3.59 ± 1.9 (D0), 3.4 ± 1.7 (D1), and 2.1 ± 1.5 (D2); lower extremity surgery - 4.1 ± 2.1 (D0), 3.49 ± 1.42 (D1), and 2.58 ± 1.4 (D2); spine surgery - 3.31 ± 1.58 (D0), 2.88 ± 1.96 (D1), and 1.83 ± 1.74 (D2). Patients in the lower extremity group experienced unacceptable mean pain. The maximum pain intensity on day of surgery was experienced by patients after single-shot plexus brachialis block anaesthesia (5.24 ± 2.4). Well-designed multimodal analgesia with special attention to single shot techniques may improve pain management and functional outcomes after orthopaedic surgery.

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