Pain assessment and post-operative pain management in orthopedic patients

2017 ◽  
Vol 16 (1) ◽  
pp. 181-181
Author(s):  
W. Schmelling ◽  
J.N. Poulsen ◽  
L. Christrup ◽  
P. Gazerani
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Postoperative Pain ◽  
Potential Risk ◽  
Health Care Professionals ◽  
Sleep Disturbances ◽  
Pain Treatment ◽  
Early Mobilization ◽  
Postoperative Pain Management ◽  
Orthopedic Patients

Abstract Aims A fast-track based surgical treatment reduces morbidity and hospital stay by providing early mobilization. Sufficient postoperative pain management is mandatory for early mobilization and optimal utilization of rehabilitation measures. Insufficient postoperative pain management is however a widespread problem. Lack of knowledge about pain and pain treatment among health care professionals and general community has been considered as a major potential contributor in insufficient pain management. It has been suggested that severe postoperative pain might imply a potential risk of developing chronic pain. The purpose of this study was to examine this problem in acute and elective surgical patients in department of orthopedic surgery at Bispebjerg Hospital in order to identify obstacles and possibilities for future improvement. Methods Questionnaires were developed and distributed to patients consisted of 10 acute admitted and 10 elective orthopedic patients. The patients’ pain scores were recorded with a 0–10 NRS scale. The scores were obtained for current pain in rest, current pain in activity, and the highest and lowest pain intensity for the last 24 hours. Data were handled using descriptive statistics. Results The goal for sufficient pain treatment was patients with pain score at ≤ 3 NRS at rest and ≤ 5 in activity. For pain at rest 45% of the patients were within the goal range and 55% for the current pain in activity. For the mildest pain experienced in the last 24 h, 75% and for the worst pain experienced 30% of the patients reached the goal. Conclusions Corresponding to similar studies, half of the patients received a sufficient pain treatment at the time of examination. The consequences for insufficient pain management would be reduced effect of the physiotherapy, reduced ability to handle every day activity, sleep disturbances, and potential risk of developing chronic pain.

scholarly journals Erector Spinae Block for Analgesia : A Safe and Novel Technique with Diverse Applications

2019 ◽  
Vol 2 (1) ◽  
pp. 102-104
Author(s):  
Bigen Man Shakya ◽  
Ninadini Shrestha ◽  
Binita Acharya ◽  
Anil Shrestha ◽  
Renu Gurung ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Postoperative Pain ◽  
Pain Treatment ◽  
Postoperative Pain Management ◽  
Erector Spinae ◽  
Anesthetic Technique ◽  
Contrast Study ◽  
Chronic Pain Management ◽  
Postoperative Pain Treatment

Erector Spinae Block is a paraspinal musculofascial plane block where we inject local anesthetics superficial to the tip of the transverse processes and deep to the erector spinae muscle .It works at the origin of spinal nerves based on cadaveric and contrast study. It is effective and safe regional anesthetic technique. It has a wide variety of applications ranging from acute postoperative pain treatment to chronic pain management. In this series, we report a series of two cases, which include postoperative pain management in Partial Nephrectomy and chronic pain management in Post Herpetic Neuralgia. Keywords: Analgesia; erector spinae block; regional.

Postoperative Pain Management

2018 ◽  
Author(s):  
Q. Cece Chen ◽  
Shengping Zou
Keyword(s):  
Pain Management ◽  
Postoperative Pain ◽  
Pain Treatment ◽  
Postoperative Pain Management ◽  
Cost Of Care ◽  
Patient Comfort ◽  
Treatment Modalities ◽  
Surgical Patient ◽  
Coordinated Care ◽  
Unrealistic Expectations

Postoperative pain management is an important aspect of caring for a surgical patient as inadequate pain control can be associated with increased morbidity and mortality. Failure to effectively control postoperative pain is often due to poor communication and poorly coordinated care between the care teams, poor communication with the patient, insufficient education, unrealistic expectations, fear of complications from the pain regimen, inaccurate pain assessment, and limited effective pain treatment modalities. An effective pain management can therefore lead to improved patient comfort, satisfaction, earlier ambulation, faster recovery time, decreased hospital stay and cost of care, and reduced postoperative complications.

scholarly journals Manajemen Nyeri Terkini pada Pasien Pasca Seksio Sesarea

2021 ◽  
Vol 4 (1) ◽  
pp. 63-78
Author(s):  
Muh Ramli Ahmad ◽  
Rezki Hardiyanti Taufik
Keyword(s):  
Nervous System ◽  
Pain Management ◽  
Postoperative Pain ◽  
Caesarean Section ◽  
Early Mobilization ◽  
Postoperative Pain Management ◽  
Multimodal Analgesia ◽  
Post Operative Pain ◽  
Sensitization Process ◽  
Adequate Pain Management

Prosedur Seksio Sesarea (SS) seringkali menyebabkan nyeri sedang hingga berat selama 48 jam. Tujuan manajemen nyeri pascabedah adalah untuk memberikan kenyamanan pada pasien, menghambat impuls nosiseptif, dan menumpulkan respon neuroendokrin terhadap nyeri, yang dengan demikian mempercepat kembalinya fungsi fisiologis. Selain itu, manajemen nyeri yang adekuat pada pasien SS memungkinkan mobilisasi dini untuk mencegah risiko tromboemboli yang meningkat selama kehamilan dan pasien perlu bebas nyeri untuk merawat bayi serta memberikan ASI secara efektif. Mekanisme nyeri pascabedah terdiri dari sensitisasi perifer dan senstisasi sentral dari susunan saraf. Dampak klinik sensitisasi sistem saraf berupa hiperalgesia dan alodinia. Sensitisasi pascabedah akan mengakibatkan penderitaan bagi pasien sehingga pada akhirnya dapat meningkatkan angka morbiditas dan mortalitas pascabedah, oleh karena itu manajemen nyeri pascabedah harus ditujukan ke arah pencegahan dan meminimalkan terjadinya proses sensitisasi. Analgesia multimodal dengan mengkombinasi obat yang menghambat sensitisasi perifer dan sentral, dengan opioid sebagai analgesia penyelamat dapat menjadi pilihan untuk memberikan manajemen nyeri yang adekuat dan meminimalkan efek samping.   Current Practice for Post Operative Pain Management in Caesarean Section Abstract Caesarean section (CS) is frequently followed by moderate to severe pain up to 48 hours after surgery. Postoperative pain management is aimed to provide postoperative comfortness, inhibits nociceptive impulse, and blunts neuroendocrine response to pain, thus enhance the return of physiological function. Moreover, an adequate pain management in CS patients allows early mobilization in preventing the increased of thromboemboli risk during pregnancy, the need of patients to be pain free in taking care of the baby as well as effective breastfeeding. Postoperative pain mechanism consists of peripheral and central senzitisation of nervous system. Clinical impact of nervous system sensitization including hyperalgesia and allodynia. Postoperative sensitization resulted in patient’s suffering that increase morbidity and mortality rate eventually. Therefore, postoperative pain management should be directed to prevent and minimalize sensitization process. Multimodal analgesia by combining analgesics inhibited peripheral and central sensitization, with opioid as rescue analgesic may be preferred to provide adequate pain management and to minimalize the adverse effects.

scholarly journals Comparative Study on Efficacy of Ketorolac and Pethidine for Postoperative Pain Management

2019 ◽  
Vol 7 (1) ◽  
pp. 27-32
Author(s):  
Laxmi Shrestha ◽  
Bishal Joshi ◽  
Anjan Palikhey ◽  
Kushal Bhattarai
Keyword(s):  
Pain Management ◽  
Postoperative Pain ◽  
Rating Scale ◽  
Analgesic Efficacy ◽  
Early Mobilization ◽  
Postoperative Pain Management ◽  
Sedation Score ◽  
Analgesic Effects ◽  
Postoperative Setting ◽  
Hourly Basis

INTRODUCTION: Postoperative pain management is essential for early mobilization and rehabilitation to enhance recovery and to reduce morbidity. Ketorolac and pethidine are two most common analgesics used in the postoperative setting for pain management. MATERIAL AND METHODS: Sixty patients (n=60) of age group 18-60 years who undergone various surgical procedures were divided randomly into two groups (T1 and T2). T1 group received inj. ketorolac 5 mg/kg IM and T2 group received pethidine 1.5 mg/kg IM body weight respectively on 6 hourly basis for 48 hours postoperatively. Patients were assessed in the recovery room for pain according to Visual Analogue Scale (VAS), Verbal Rating Scale (VRS) and Sedation Score after 1, 6, 12, 18, 24 and 48 hours of drug administration. Analgesic efficacy was measured using VAS and VRS. Safety of the drugs was assessed by using Sedation Score. RESULTS: Ketorolac showed equianalgesic effect as pethidine estimated by VAS score at 18th  and 48th  hour. In other periods of observation, pethidine exhibited better analgesic effects than ketorolac. However, ketorolac shows less incidence of sedation compared to pethidine. CONCLUSION: This study showed that postoperative pain during the first 48 hours can be relieved by either ketorolac or pethidine. Ketorolac appeared safer than pethidine while pethidine appeared more effective analgesic than ketorolac in the management of postoperative pain.

scholarly journals Pooperacinio skausmo malšinimo aktualijos širdies chirurgijoje

2010 ◽  
Vol 8 (1) ◽  
pp. 0-0
Author(s):  
Judita Andrejaitienė
Keyword(s):  
Cardiac Surgery ◽  
Pain Management ◽  
Postoperative Pain ◽  
Acute Pain ◽  
Postoperative Analgesia ◽  
Pain Treatment ◽  
Scientific Progress ◽  
Postoperative Pain Management ◽  
Key Words Pain ◽  
Post Operative Pain

Judita AndrejaitienėKauno medicinos universiteto Biomedicininių tyrimų instituto Intensyviosios terapijos ir kraujotakos tyrimų laboratorija,Eivenių g. 4, LT-50009 KaunasEl paštas: [email protected] Veiksmingas pooperacinio skausmo valdymas yra šiuolaikinio chirurginio gydymo sudedamoji dalis. Neadekvatus skausmo gydymas po širdies operacijų lemia sumažėjusį ligonių aktyvumą, sukelia emocinį diskomfortą, nerimą, sutrikdo miegą, neigiamai veikia kvėpavimo funkciją, padidina miokardo infarkto, širdies nepakankamumo, tromboembolinių komplikacijų riziką. Tinkamas pooperacinio skausmo malšinimas ne tik gerina ligonio gyvenimo kokybę, pagreitina sveikimą ir visišką funkcijų atsitaisymą, bet ir glaudžiai susijęs su ligonio gydymo stacionare trukme, sumažina gydymo išlaidas. Pooperacinio skausmo gydymo svarba jau seniai neabejojama. Nors informacijos apie ūminio skausmo patogenezę ir jo gydymo patirties sukaupta nemažai, deja, nėra priimto skausmo malšinimo po širdies operacijų „aukso standarto“, o taikomų metodų efektyvumas nėra pakankamai aiškus. Pagrindinis straipsnio tikslas – padėti suprasti gydytojui praktikui, kodėl kyla skausmo problema pooperaciniu laikotarpiu ir ką gali medicinos personalas padaryti, kad šis laikotarpis pacientui būtų kuo sklandesnis. Straipsnyje aptariami ir nauji po širdies operacijų taikomi veiksmingi skausmo malšinimo metodai. Reikšminiai žodžiai: skausmas, širdies operacija, ūminio pooperacinio skausmo malšinimas New trends in the treatment of postoperative pain in cardiac surgery Judita AndrejaitienėInstitute for Biomedical Research, Kaunas University of Medicine, Laboratory of Intensive Care and Blood Circulation Research,Eivenių Str. 4, LT-50009 Kaunas, LithuaniaE-mail: [email protected] Effective post-operative pain management is a constituent of contemporary surgical treatment. Inadequate acute pain treatment after cardiac surgery can keep patients from the activities that prevent postoperative complications, especially respiratory complications, determine reduced patients’ emotional discomfort, anxiety, sleep disorders. The appropriate postoperative analgesia prevents patients’ discomfort, may decrease morbidity, postoperative ICU and in-hospital stay, and thus may decrease cost. The importance of post-operative pain management has been known for a long time. However, regardless of scientific progress in the studies of acute pain pathogenesis and the accumulated treatment experience, there is no acknowledged “golden standard” for the periods following cardiac surgery, while the effectiveness of the applied methods has not yet been fully explained. In the current era of early tracheal extubation, achieving optimal pain relief after cardiac surgery can be challenging. Adequate postoperative analgesia after cardiac surgery may be attained via a wide variety of techniques. The main purpose of this article is to help a practicing doctor understand the reasons related to the problem of pain during the postoperative period and also what the medical personnel can do in order to make this period as smooth as possible for the patient. The article also covers the most recently adapted effective methods of post-operative analgesia. Key words: pain, cardiac surgery, acute postoperative pain management

Prevention of Adverse Effects in Perioperative Pain Management for General and Plastic Surgeons

2018 ◽  
Author(s):  
Daniel Krashin ◽  
Natalia Murinova ◽  
Alan D. Kaye
Keyword(s):  
Pain Management ◽  
Postoperative Pain ◽  
Pain Treatment ◽  
Postoperative Pain Management ◽  
Opioid Therapy ◽  
Perioperative Pain ◽  
Perioperative Pain Management ◽  
Complicating Factors ◽  
Multimodal Pain Treatment ◽  
Poor Outcomes

Postoperative pain management is a key part of perioperative care. Inadequately controlled pain contributes to poor outcomes and patient satisfaction. Overmedication with opioids for postoperative pain also leads to complications and slows recovery. Perioperative pain care starts with thorough evaluation at the preoperative visit. Multimodal pain treatment reduces the reliance on opioids and tends to improve outcomes. Many complicating factors, including pregnancy, comorbid psychological and medical conditions, addiction, and chronic opioid therapy need to be identified and addressed in a personalized pain plan. Complications including delirium and opioid-induced respiratory suppression are also discussed.

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