Postoperative pain management on surgical wards—do quality assurance strategies result in long-term effects on staff member attitudes and clinical outcomes?

Paediatric pain management has made great strides in the past few decades in the understanding of developmental neurobiology, developmental pharmacology, the use of analgesics in children, the use of regional techniques in children, and of the psychological needs of children in pain. The consequences of a painful experience on the young nervous system are so significant that long-term effects can occur, resulting in behavioural changes and a lowered pain threshold for months after a painful event. Accurate assessment of pain in different age groups and the effective treatment of postoperative pain are constantly being refined, with newer drugs being used alone and in combination with other drugs, and continue to be explored. Systemic opioids, paracetamol, non-steroidal anti-inflammatories, and regional anaesthesia alone or combined with additives are currently used to provide effective postoperative analgesia. These modalities are often best utilized when combined as a multimodal approach to treat acute pain in the perioperative setting. The safe and effective management of pain in children includes the prevention, recognition, and assessment of pain; early and individualized treatment; and evaluation of the efficacy of treatment. This chapter discusses selected topics in paediatric acute pain management, with more specific emphasis placed on pharmacology and regional anaesthesia in the treatment of acute postoperative pain management.

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The effect of simulation based training on clinical outcomes of nursing students on postoperative pain management

Journal of Human Sciences ◽

10.14687/jhs.v17i2.6008 ◽

2020 ◽

Vol 17 (2) ◽

pp. 720-729

Author(s):

Hilal Tüzer ◽

Tuba Yılmazer

Keyword(s):

Performance Evaluation ◽

Pain Management ◽

Nursing Students ◽

Postoperative Pain ◽

Clinical Outcomes ◽

Postoperative Pain Management ◽

Clinical Nurses ◽

Standard Patient ◽

Simulation Based ◽

And Performance

Objective: This study was conducted to assess the effectiveness of simulation-based education for postoperative pain management and pain management on pain-related clinical outcomes. Methods: The study was carried out with 119 patients and 14 nursing students. The study was conducted in 3 periods. In the pre-education period, patients were followed by clinical nurses. During the education period, theoretical education was given to the students pre-test was performed and then the first performance evaluation was conducted with the standard patient. Then, one week later, pain assessment was explained with the standard patient and the students were allowed to work free of charge. In the post- education period, the students were given clinical practice and data about the patients were followed up by clinical nurses. In this period, the second performance evaluation was performed with the real patient and the post-test was performed. At the end of the study, the effectiveness of simulation based education and clinical outcomes related to pain were evaluated. Results: Students' knowledge and performance scores related to pain management after simulation education increased significantly (p<0.002). Conclusion: As a result, it is seen that students' knowledge and performance related to pain management have changed positively after simulation training. In addition, further decrease in pain level on post-op 2nd day is considered to be an important clinical outcome in inpatients in the post-training period. Extended English summary is in the end of Full Text PDF (TURKISH) file. Özet Amaç: Bu araştırmanın amacı ameliyat sonrası ağrı yönetimine ilişkin öğrencilere verilen simülasyon temelli eğitimin etkinliğini ve ağrıyla ilgili klinik sonuçlara etkisini belirlemektir. Yöntem: Araştırma 119 hasta ve 14 öğrenci hemşire ile yürütülmüştür. Araştırma 3 aşamada gerçekleştirilmiştir. Eğitim öncesi dönemde hastalar klinik hemşireleri tarafından takip edilmiştir. Eğitim döneminde, öğrencilere teorik eğitim verilerek ön-test yapılmış ve ardından standart hasta eşliğinde 1. performans değerlendirmesi yapılmıştır. 1 hafta sonra standart hasta eşliğinde ağrı yönetimi anlatılarak öğrenciler serbest çalışmaya bırakılmıştır. Eğitim sonrası dönemde öğrenciler klinik uygulamaya çıkarılmış ve bu dönemde de hastalara ilişkin veriler klinik hemşireleri tarafından takip edilmiştir. Daha sonra gerçek hasta eşliğinde 2. performans değerlendirmesi yapılarak son-test yapılmıştır. Çalışma sonunda simülasyon temelli eğitimin etkinliği ve ağrıyla ilgili klinik sonuçlar değerlendirilmiştir. Bulgular: Öğrencilerin simülasyon eğitimi sonrası ağrı yönetimine ilişkin bilgi ve performans puanları anlamlı oranda artmıştır (p<0.002). Sonuç: Sonuç olarak, öğrencilerin simülasyon eğitimi sonrası ağrı yönetimine ilişkin bilgi ve performanslarının olumlu olarak değiştiği görülmektedir. Ayrıca eğitim sonrası dönemde yatan hastalarda post-op 2. gün ağrı düzeyinin daha fazla azalmasının oldukça önemli bir klinik sonuç olduğu düşünülmektedir.

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Postoperative Pain Management

Canadian Journal of General Internal Medicine ◽

10.22374/cjgim.v16isp1.529 ◽

2021 ◽

Vol 16 (SP1) ◽

pp. 5-17

Author(s):

Yusuke Mazda ◽

Sandra Jadin ◽

James S. Kahn

Keyword(s):

Pain Management ◽

Postoperative Pain ◽

Acute Pain ◽

Management Strategies ◽

Postoperative Pain Management ◽

Douleur Postopératoire ◽

Basic Understanding ◽

Interventional Pain Management ◽

Short And Long Term

ABSTRACTAfter surgery, over 80% of people experience moderate-to-severe acute pain. Poorly controlled postoperative pain limits recovery and is associated with detrimental short- and long-term morbidity. While surgeons have traditionally been responsible for postoperative pain management, all clinicians providing care for surgical patients have a basic understanding of common pharmacologic and interventional pain management strategies. In this review, we discuss the consequences of acute pain, approaches to pain assessment, and an overview of commonly used therapies to manage postoperative pain. RÉSUMÉAprès une opération, plus de 80 % des gens ressentent des douleurs aiguës modérées à intenses. Une douleur postopératoire mal maîtrisée limite le rétablissement et est associée à une morbidité défavorable à court et à long terme. Bien que les chirurgiens soient habituellement responsables du traitement de la douleur postopératoire, il est impératif que tous les cliniciens qui soignent des patients ayant subi une intervention chirurgicale aient une connaissance de base des stratégies pharmacologiques et interventionnelles courantes relatives au traitement de la douleur. Dans cette revue, nous abordons les conséquences de la douleur aiguë, les approches de l’évaluation de la douleur et un aperçu des traitements couramment utilisés pour traiter la douleur postopératoire.

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Postoperative pain management—impact of quality assurance and audit documentation on clinical outcome

Current Anaesthesia and Critical Care ◽

10.1016/j.cacc.2003.10.002 ◽

2003 ◽

Vol 14 (5-6) ◽

pp. 217-221 ◽

Cited By ~ 3

Author(s):

M Warrén Stomberg ◽

H Haljamäe

Keyword(s):

Quality Assurance ◽

Pain Management ◽

Postoperative Pain ◽

Clinical Outcome ◽

Postoperative Pain Management

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Preemptive Infiltration with Betamethasone and Ropivacaine for Postoperative Pain in Laminoplasty or Laminectomy (PRE-EASE): A Study Protocol

10.21203/rs.2.21327/v1 ◽

2020 ◽

Author(s):

Niti Shrestha ◽

Liang Wu ◽

Xianodi Wang ◽

Wenqing Jia ◽

Fang Luo

Keyword(s):

Postoperative Pain ◽

Local Anesthetic ◽

Postoperative Pain Management ◽

Control Group ◽

Long Term Effects ◽

Open Label ◽

Local Infiltration ◽

Short Period ◽

Severe Postoperative Pain

Abstract Background: Laminoplasty and laminectomy have been used for decades for the treatment of intraspinal space occupying lesions, spinal stenosis, disc herniation, injuries, etc. After these procedures, patients often experience severe postoperative pain at the surgical site. Intense immediate postoperative pain after many spinal procedures makes its control of utmost importance.Preemptive injection of local anesthetics can significantly reduce postoperative pain during rest and movement, however, the analgesic effect is maintained for a relatively short period of time. Whether betamethasone combined with local anesthetic for laminoplasty or laminectomyhas better short-term and long-term effects than the local anesthetic alone has not been reported yet. Method: The PRE-EASEtrial is a prospective, randomized, open-label, blinded endpoint, single-center clinical study including 116 participants scheduled for elective laminoplasty or laminectomy, with a 6 months’ follow-up process. Preemptive local infiltration with betamethasone and ropivacaine (treatment group) or ropivacaine alone (control group) throughout the entire thickness of the planned incision site will be performed by the surgeon, prior to making the incision. The primary outcome will be the cumulative butorphanol consumption within the first 48 hours’ postoperative period. Discussion: This study will add significant new knowledge to the effect and feasibility of preemptive local infiltration of betamethasone for postoperative pain management in laminoplasty and laminectomy.

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Peri- and Postoperative Pain Management in Multiple Ligament Knee Surgery in the Hospital and Ambulatory Surgery Center Setting

The Journal of Knee Surgery ◽

10.1055/s-0039-1698746 ◽

2019 ◽

Vol 33 (04) ◽

pp. 320-327

Author(s):

David Gregory Fanelli ◽

To-Nhu Vu

Keyword(s):

Pain Management ◽

Postoperative Pain ◽

Knee Injury ◽

Postoperative Pain Management ◽

Multimodal Analgesia ◽

Injury Pattern ◽

Multiligament Knee Injury ◽

Intraoperative Management ◽

Persistent Postoperative Pain

AbstractThe multiligament knee injury presents as a complex injury pattern that has substantial potential to cause long-term disability. Patients who sustain this injury pattern experience significant pain not only immediately following injury but also throughout the perioperative and postoperative period. Treating pain with major orthopaedic procedures is challenging but technical success of a surgical repair becomes trivial when pain is not effectively managed. This article will (1) provide an outline of the types of pain most often sustained in the multiligament knee injury, (2) outline the phases of pain management for this injury, and (3) provide an overview of persistent postoperative pain. The principles of multimodal analgesia in combination with effective regional anesthesia and attentive intraoperative management can position patients for successful rehabilitation and recovery.

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