Postoperative pain

2020 ◽  
pp. 85-96
Author(s):  
Anne Craig ◽  
Anthea Hatfield
Keyword(s):  
Postoperative Pain ◽  
Acute Pain ◽  
Myocardial Ischaemia ◽  
The Elderly ◽  
Multimodal Analgesia ◽  
Day Surgery ◽  
Acute Pain Service ◽  
Nerve Blocks ◽  
Pain Scales ◽  
Mentally Impaired

This chapter begins with a list of pain principles. It goes on to describe misunderstandings about pain and guidelines are given for diagnosing non-surgical causes of pain, such as myocardial ischaemia. Gauging the severity of pain and using pain scales are explained as well as the use of an acute pain service. Different techniques are described for assessing pain in different groups including the elderly, neonates, and the mentally impaired. Pre-emptive analgesia and multimodal analgesia are discussed. Suggestions for looking after patients with nerve blocks and day surgery patients are offered.

Postoperative pain

2014 ◽  
Author(s):  
Anthea Hatfield
Keyword(s):  
Postoperative Pain ◽  
Acute Pain ◽  
Myocardial Ischaemia ◽  
The Elderly ◽  
Multimodal Analgesia ◽  
Day Surgery ◽  
Acute Pain Service ◽  
Nerve Blocks ◽  
Pain Scales ◽  
Mentally Impaired

This chapter begins with a list of pain principles. It goes on to describe misunderstandings about pain and guidelines are given for diagnosing non-surgical causes of pain, such as myocardial ischaemia. Gauging the severity of pain and using pain scales are explained as well as the use of an acute pain service. Different techniques are described for assessing pain in different groups including the elderly, neonates, and the mentally impaired. Pre-emptive analgesia and multimodal analgesia are discussed. Suggestions for looking after patients with nerve blocks and day surgery patients are offered.

Costs and benefits of an acute pain service in postoperative pain management

2011 ◽  
Vol 28 ◽  
pp. 194
Author(s):  
G. Garufi ◽  
D. Caristi ◽  
T. Bigolin ◽  
L. Pasa ◽  
B. Presello ◽  
...  
Keyword(s):  
Pain Management ◽  
Postoperative Pain ◽  
Acute Pain ◽  
Postoperative Pain Management ◽  
Acute Pain Service ◽  
Costs And Benefits

scholarly journals Monitoring Acute Pain in Donkeys with the Equine Utrecht University Scale for Donkeys Composite Pain Assessment (EQUUS-DONKEY-COMPASS) and the Equine Utrecht University Scale for Donkey Facial Assessment of Pain (EQUUS-DONKEY-FAP)

Animals ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. 354 ◽  
Author(s):  
Machteld C. van Dierendonck ◽  
Faith A. Burden ◽  
Karen Rickards ◽  
Johannes P.A.M. van Loon
Keyword(s):  
Postoperative Pain ◽  
Acute Pain ◽  
Pain Assessment ◽  
Pain Scale ◽  
Follow Up Study ◽  
Observer Reliability ◽  
Pain Scales ◽  
Different Types ◽  
Good For

Objective pain assessment in donkeys is of vital importance for improving welfare in a species that is considered stoic. This study presents the construction and testing of two pain scales, the Equine Utrecht University Scale for Donkey Composite Pain Assessment (EQUUS-DONKEY-COMPASS) and the Equine Utrecht University Scale for Donkey Facial Assessment of Pain (EQUUS-DONKEY-FAP), in donkeys with acute pain. A cohort follow-up study using 264 adult donkeys (n = 12 acute colic, n = 25 acute orthopaedic pain, n = 18 acute head-related pain, n = 24 postoperative pain, and n = 185 controls) was performed. Both pain scales showed differences between donkeys with different types of pain and their control animals (p < 0.001). The EQUUS-DONKEY-COMPASS and EQUUS-DONKEY-FAP showed high inter-observer reliability (Cronbach’s alpha = 0.97 and 0.94, respectively, both p < 0.001). Sensitivity of the EQUUS-DONKEY-COMPASS was good for colic and orthopaedic pain (83% and 88%, respectively), but poor for head-related and postoperative pain (17% and 21%, respectively). Sensitivity of the EQUUS-DONKEY-FAP was good for colic and head-related pain (75% and 78%, respectively), but moderate for orthopaedic and postoperative pain (40% and 50%, respectively). Specificity was good for all types of pain with both scales (91%–99%). Different types of acute pain in donkeys can be validly assessed by either a composite or a facial expression-based pain scale.

Evaluation of targeted bupivacaine for reducing acute postoperative pain in cats undergoing routine ovariohysterectomy

2019 ◽  
Vol 22 (2) ◽  
pp. 91-99 ◽  
Author(s):  
James Mack Fudge ◽  
Bernie Page ◽  
Amy Mackrell ◽  
Inhyung Lee
Keyword(s):  
Postoperative Pain ◽  
Acute Pain ◽  
Rating Scale ◽  
High Volume ◽  
Pain Scale ◽  
Placebo Control ◽  
Controlled Clinical Trial ◽  
Colorado State University ◽  
Pain Scores ◽  
Pain Scales

Objectives This study sought to determine if bupivacaine targeted at specific, potentially painful sites could enhance postoperative analgesia in routine feline ovariohysterectomies. A secondary objective was to assess the utility of multiple acute pain scales for cats in a high-volume surgery setting. Methods Two hundred and twelve cats were included in a prospective, randomized, double-blinded, placebo-controlled clinical trial. Anesthesia included buprenorphine, ketamine, dexmedetomidine and isoflurane. A ventral midline ovariohysterectomy was performed and cats were administered bupivacaine (2 mg/kg), placebo control (0.9% saline) or sham control (observation only) intraoperatively at the ovarian suspensory ligaments and vessels, uterine body and incisional subcutaneous tissues. Two pain scales were used to assess cats postoperatively. Initially, a multidimensional composite pain scale (MCPS) and a 0–10 numeric pain rating scale (NRS) were used. Subsequently, the MCPS was replaced with a modified Colorado State University Feline Acute Pain Scale (mCSU). Pain scores for the test groups were compared using a one-way ANOVA and a Holm–Bonferroni post hoc analysis when a difference was found ( P <0.05). Results Pain for the bupivacaine group was lower than the control groups at 1 h post-recovery and discharge, attaining significance with higher body weights. The P values were 0.008 and 0.004 for 1 h post-recovery and discharge, respectively. Pain scores between evaluators for the MCPS and NRS correlated poorly with r values for 1 h post-recovery and discharge of −0.08 and 0.22, respectively. Additionally, the MCPS proved difficult to use and time consuming, especially for feral and fractious patients, and was replaced with the mCSU. Conclusions and relevance Targeted bupivacaine reduced early postoperative pain scores following routine feline ovariohysterectomies. The technique used was simple, requiring just over a minute to perform at minimal additional cost. The MCPS was not ideal for use in a high-volume spay setting.

scholarly journals Regional Anesthesia in the Prevention of Chronic Postoperative Pain

2021 ◽  
Author(s):  
Brenda O. Lezcano Velazquez ◽  
Guillermo A. Castorena Arellano
Keyword(s):  
Postoperative Pain ◽  
Regional Anesthesia ◽  
Healing Process ◽  
Psychosocial Problems ◽  
Female Gender ◽  
Multimodal Analgesia ◽  
Pulmonary Complications ◽  
Nerve Blocks ◽  
Chronic Postsurgical Pain ◽  
Ectopic Firing

Chronic postsurgical pain (CPSP) develops after a surgical procedure but increases its intensity and persists beyond the healing process without another cause to explain it. The incidence ranges from 5–85%, according to the type of surgery. Patients who develop CPSP may have a protracted ambulation, cardiac and pulmonary complications and increased morbidity and mortality. Several risk factors have been found related to the development of CPSP: female gender, young age, genetic predisposition, and psychosocial problems, hence prevention, early identification and treatment of these factors is essential. Several guidelines recommend the use of multimodal analgesia to treat postoperative pain, and the perioperative management seems to have a preventive role in the development of CPSP. Regional anesthesia (RA) either neuraxial or peripheral nerve blocks, by modulating signaling created by a surgical incision, play a key role in the prevention of CPSP. Local anesthetics have anti-inflammatory properties which decrease sensitization, reduce ectopic firing of neurons, cytokines expression and decrease neutrophil priming. RA reduces pain signals to the spinal cord and supraspinal and cortical nociceptive centers. RA along with other pharmacologic interventions can improve the CPSP as well as the physical and social functionality.

scholarly journals Acute postoperative pain

2016 ◽  
Vol 11 (3) ◽  
pp. 231-233
Author(s):  
Adriana Alexandra BRĂDIŞ ◽  
◽  
Adrian Daniel TULIN ◽  
Erick NESTIANU ◽  
Ioana Anca BĂDĂRĂU ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Postoperative Pain ◽  
Postoperative Morbidity ◽  
Emotional Experience ◽  
Multimodal Analgesia ◽  
Postoperative Recovery ◽  
Psychological Effects ◽  
Acute Postoperative Pain ◽  
Pain Scales

Acute postoperative pain is a personal unpleasant sensory and emotional experience with negative physiological and psychological effects. Severe acute pain may increase postoperative morbidity and mortality and is a risk factor for chronic pain incidence. We evaluate pain intensity using pain scales. Pain management includes preventive analgesia who interacts and modulates central sensitization response and multimodal analgesia which uses two or more different analgesic mechanisms agents for a superior analgesic effect. Effective pain management provide early postoperative recovery and decrease the incidence of chronic pain.

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