Oral and Parenteral Opioid Analgesics for Acute Pain Management

2009 ◽  
pp. 188-203 ◽  
Author(s):  
Raymond S. Sinatra ◽  
Henry McQuay
Keyword(s):  
Pain Management ◽  
Acute Pain ◽  
Opioid Analgesics ◽  
Acute Pain Management

Two hundred days of nurse practitioner prescribing and role development: a case study report from a hospital-based acute pain management team

2011 ◽  
Vol 35 (4) ◽  
pp. 444 ◽  
Author(s):  
Anthony V. Schoenwald
Keyword(s):  
Pain Management ◽  
Acute Pain ◽  
Nurse Practitioner ◽  
Management Practice ◽  
Opioid Analgesics ◽  
Healthcare Setting ◽  
Major Surgery ◽  
Role Development ◽  
Acute Pain Management ◽  
Pain Services

Purpose. This report evaluates a beginning Nurse Practitioner (NP) role in Acute Pain Management. Healthcare setting. The role was implemented within an anaesthesiology-based pain service. The NP author developed this pain service in 2002 and was endorsed as an NP 6 years later. The NP reviews all clients undergoing major surgery or trauma and provides pain management to women for caesarean section. Prior to this role, there were significant delays for some patients requiring prompt analgesia. This was because of the decreased availability of anaesthetists to fully participate in the pain service due to the demand for complex anaesthesiology practice. Method of data collection. Data were conveniently collected by the NP on prescription and service provision over 200 working days. Main findings. Therapeutic activity reflected contemporary pain management practice and espouse the NP as a safe and effective clinician. The role has improved patient access to pain management through the prompt use of non-pharmacological interventions, drugs used to treat analgesic side effects, opioids and non-opioid analgesics. Principal conclusions. These initial positive outcomes are consistent with NP role development described elsewhere in Australia and overseas across a variety of healthcare settings. To sustain this role, robust continuing education and clinical support is required. What is known about the topic? There is little published information on the development of the Nurse Practitioner (NP) role in acute pain services in Australia or overseas. The acute pain role is a new development in Australia and so previous descriptions of NP practice have focussed on other specialty areas such as Emergency or Mental Health. What does this paper add? This report demonstrates positive and safe client outcomes as a result of a NP role in acute pain management. More importantly, it may contribute to accumulating evidence that NPs are safe prescribers of opioids and other analgesics in acute settings. What are the implications for practitioners? Novice NPs and Candidates practising in this specialty need to use this information as support for their own role development and implementation in other acute pain services in Australia.

scholarly journals (A72) Efficacy of Parental Opioid Analgesics versus Non-Opioid Analgesic in Acute Pain Management of Trauma Victims in the Emergency Department

2011 ◽  
Vol 26 (S1) ◽  
pp. s20-s20
Author(s):  
G. Adhikari ◽  
S. Bhoi ◽  
P. Gautam ◽  
T.P. Sinha ◽  
M. Rodha ◽  
...  
Keyword(s):  
Emergency Department ◽  
Pain Management ◽  
Acute Pain ◽  
Opioid Analgesic ◽  
Opioid Analgesics ◽  
Acute Pain Management ◽  
Vas Score ◽  
Group A ◽  
Trauma Victims ◽  
Group B

BackgroundThe pyramid of pain management involves sequential drug escalation but its role is limited in an emergency department (ED). The efficacy of parental opioid analgesics versus non-opioid analgesic in acute pain management of trauma victims in the ED was evaluated to formulate protocol.MethodsAll alert patients with a baseline visual analogue scale score (≥ 7) was randomly assigned either parental non-opioid (Group A) or opioid analgesics (Group B). The emergency care providers noted the VAS in either group at 15 minutes, 30 minutes, and 60 minutes, and at the time of discharge from the ED. If the patient's VAS score did not reduce by 50% at 30 minutes, repeat parental analgesics was given. The oral analgesics prescribed at the time of discharge were documented. Ethical clearance was taken. Data was compiled and analyzed.ResultsOf 106 patients, 99 were analyzed. The mean age in Group A was 33.2 ± 13.2 years and 32.5 ± 18 years in Group B. The male:female ratio in Group A was 1.5:1 and 7:1 in Group B. The average baseline VAS score in Group A was 7.5, and that of Group B was 8.96. The average VAS at 15, 30, and 60 minutes and at discharge in Group A was 5.4, 5.34, 4.3, and 3.5 and it was 6.1, 6, 5.1, and 4.4. Repeat parental dose of analgesics were required in 95/99 (95%) patients in Group A and 5% that of Group B. The most common prescription at discharge from ED was non-opioid analgesics.ConclusionsAcute pain relief was comparable in both groups. Non-opioid analgesics may be preferred over opioid in VAS score ± 7 in a busy emergency department for early disposition.

Acute Pain Management: Operative or Medical Procedures and Trauma

1997 ◽  
Vol 31 (9) ◽  
pp. 1068-1076 ◽  
Author(s):  
Sheryl L Follin ◽  
Scott L Charland
Keyword(s):  
Clinical Practice ◽  
Pain Management ◽  
Acute Pain ◽  
Clinical Practice Guideline ◽  
Practice Guideline ◽  
Pain Assessment ◽  
Opioid Analgesics ◽  
Data Sources ◽  
Medical Procedures ◽  
Acute Pain Management

Objective To review the topics presented in the Agency for Health Care Policy and Research (AHCPR) Clinical Practice Guideline for Acute Pain Management and provide updated information on therapeutic issues as necessary. Data Sources AHCPR Clinical Practice Guideline for Acute Pain Management: Operative or Medical Procedures and Trauma. A MEDLINE search (1990 to June 1996) of English-language literature pertaining to pain assessment and management was performed. Reference lists from relevant articles also served as a literature source. Study Selection and Data Extraction All articles identified from the data sources were evaluated. Relevant information, as determined by the authors, was included in the review. Data Synthesis Inadequate acute pain management continues to be recognized as a problem due to limited health professional education on the treatment of pain, inadequate patient empowerment, negative connotations associated with opioid analgesics (e.g., fear of “addiction”), federal regulations associated with prescribing opioid analgesics, and difficulty in assessing pain. The widespread inadequacy in pain management prompted the development of the AHCPR Clinical Practice Guideline for Acute Pain Management, which was published in 1992. In addition to reviewing the pain guideline, this article includes updated information on ketorolac tromethamine, tramadol, local anesthetics, sedation, regional anesthetic techniques, and the management of opioid adverse effects. Conclusions The AHCPR Clinical Practice Guideline for Acute Pain Management is a comprehensive, yet functional, review for clinicians. Most issues relating to acute pain assessment and management are adequately discussed. Overall, this guideline is a worthwhile general resource to clinicians. It is important, however, for clinicians managing acute pain issues to supplement this guideline with more detailed and current information.

Acute pain management in trauma: anatomy, ultrasound-guided peripheral nerve blocks and special considerations

2019 ◽  
Vol 85 (7) ◽  
Author(s):  
Theodosios Saranteas ◽  
Iosifina Koliantzaki ◽  
Olga Savvidou ◽  
Marina Tsoumpa ◽  
Georgia Eustathiou ◽  
...  
Keyword(s):  
Pain Management ◽  
Peripheral Nerve ◽  
Acute Pain ◽  
Ultrasound Guided ◽  
Acute Pain Management ◽  
Nerve Blocks ◽  
Peripheral Nerve Blocks

Role of Paracetamol in Acute Pain Management

Drugs ◽  
2003 ◽  
Vol 63 (Special Issue 2) ◽  
pp. 15-21 ◽  
Author(s):  
Henrik Kehlet ◽  
Mads Utke Werner
Keyword(s):  
Pain Management ◽  
Acute Pain ◽  
Acute Pain Management

scholarly journals Knowledge, attitudes, and practices of Cameroonian physicians with regards to acute pain management in the emergency department: a multicenter cross-sectional study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Paul Owono Etoundi ◽  
Junette Arlette Metogo Mbengono ◽  
Ferdinand Ndom Ntock ◽  
Joel Noutakdie Tochie ◽  
Dominique Christelle Anaba Ndom ◽  
...  
Keyword(s):  
Emergency Department ◽  
Pain Management ◽  
Acute Pain ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Acute Pain Management ◽  
Cross Sectional ◽  
Attitudes And Practices ◽  
Knowledge Attitudes And Practices

scholarly journals Assessment for acute pain management in post-total knee replacement (TKR): a prospective cohort study in two Saudi Arabian medical centers

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Mariam Ahmad Alameri ◽  
Syed Azhar bin Syed Sulaiman ◽  
Abdullah Moh’d Talaat Ashour ◽  
Ma’ad Faisal Al-Saati
Keyword(s):  
Cohort Study ◽  
Pain Management ◽  
Total Knee Replacement ◽  
Acute Pain ◽  
Joint Replacement ◽  
Acute Pain Management ◽  
Analgesic Treatment ◽  
Pain Management Index ◽  
Medical Centers ◽  
Total Knee

Abstract Background Acute pain in post joint replacement surgeries is common, which makes the management of acute pain following joint replacement surgeries to be very important. Thus, this study was conducted to evaluate acute pain management of post TKR surgeries. Results Patients with negative pain management index (PMI) scores were classified as receiving inadequate analgesic treatment for their pain. Zero PMI was the most frequent score among the others with 195 (80.6%). The rest were − 1 (11 (4.5%)), 1 (27 (11.2%)), and 2 (9 (3.7%)), respectively. Only 4.5% (11/242) patients have negative PMI score, which could be considered as inadequate pain management in which these patients received inadequate analgesic treatment. Conclusion Acute pain management in post-TKR surgeries in both medical centers achieved an acceptable level, and majority of patients received an adequate analgesia in post-TKR surgeries.

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