Managing acute pain after abdominal surgery: examples from practice

2020 ◽  
Vol 2 (2) ◽  
pp. 78-83
Author(s):  
Nurhayati Nurhayati ◽  
Mayoora Madsiri
Keyword(s):  
Pain Management ◽  
Abdominal Surgery ◽  
Acute Pain ◽  
Assessment Tool ◽  
Pain Treatment ◽  
High Incidence ◽  
Preoperative Information ◽  
Delayed Recovery ◽  
Pain At Rest ◽  
Adequate Management

Following abdominal surgery, ischaemia and neuropeptide release cause pain at the trauma site, and there is a high incidence of moderate-to-severe pain. Inadequate pain management leads to complications, delayed recovery and prolonged hospitalisation, and thus, effective management is essential. This article describes an implementation of acute pain management after abdominal surgery. A multidimensional assessment tool collected data on demographics, medical history and surgical situation, as well as interventions used, their administration route and their side effects. Pain level was recorded on a scale of 0–10, both at rest and during physical activity, by postoperative day; patient participation and satisfaction were also recorded. Nine patients met the inclusion criteria for the study. Pharmacological analgesic interventions included opioids (morphine, fentanyl and tramadol) and paracetamol. Administration was either intravenous, epidural or via patient-controlled analgesia. These were combined with non-pharmacological interventions, specifically cold gel packs, massage therapy and music therapy. All patients achieved the adequate management goals of pain at rest below 3/10 and during activity below 4/10, and all participated in pain decision-making, were satisfied with pain treatment, and reported the usefulness of preoperative information. Pain management following abdominal surgery is vital, and the use of a combination of pharmacological and non-pharmacological techniques was effective.

Managing acute pain after abdominal surgery: examples from practice

2019 ◽  
Vol 17 (8) ◽  
pp. 20-25
Author(s):  
Nurhayati Nurhayati ◽  
Mayoora Madsiri
Keyword(s):  
Pain Management ◽  
Abdominal Surgery ◽  
Acute Pain ◽  
Assessment Tool ◽  
Pain Treatment ◽  
High Incidence ◽  
Preoperative Information ◽  
Delayed Recovery ◽  
Pain At Rest ◽  
Adequate Management

Background: Following abdominal surgery, ischaemia and neuropeptide release cause pain at the trauma site, and there is a high incidence of moderate-to-severe pain. Inadequate pain management leads to complications, delayed recovery and prolonged hospitalisation, and thus, effective management is essential. This study describes an implementation of acute pain management after abdominal surgery. Methods: A multidimensional assessment tool collected data on demographics, medical history and surgical situation, as well as interventions used, their administration route and their side effects. Pain level was recorded on a scale of 0–10, both at rest and during physical activity, by postoperative day. Patient participation and satisfaction were also recorded. Results: Nine patients met the inclusion criteria. Pharmacological analgesic interventions included opioids (morphine, fentanyl and tramadol) and paracetamol. Administration was either intravenous, epidural or via patient-controlled analgesia. These were combined with non-pharmacological interventions, specifically cold gel packs, massage therapy and music therapy. All patients achieved the adequate management goals of pain at rest below 3/10 and during activity below 4/10, and all participated in pain decision-making, were satisfied with pain treatment, and reported the usefulness of preoperative information. Conclusions: Pain management following abdominal surgery is vital, and the use of a combination of pharmacological and non-pharmacological techniques was effective.

scholarly journals POST-OPERATIVE PAIN RELIEF FOR LOWER ABDOMINAL SURGERY

2005 ◽  
Vol 12 (03) ◽  
pp. 340-345
Author(s):  
ROBINA FIRDOUS
Keyword(s):  
Pain Management ◽  
Side Effects ◽  
Pain Relief ◽  
Abdominal Surgery ◽  
Opioid Receptors ◽  
Acute Pain ◽  
Alternate Route ◽  
Parenteral Route ◽  
Group I ◽  
Post Operative Pain

The severity of post-operative pain and the lack of efforts in relievingit have led to the involvement of Anaesthesiologists in the management of post-operative and acute pain. Parenteralopiates have been utilized for post-operative pain management. The identification of the opioid receptors on substantiagelatinosa has provided an alternate route i.e 1 the epidural route - for administering opiates. Objectives: To evaluateand compare the efficacy and side effects of parenteral Buprenorphine with those of Extradural Buprenorphine.Setting: Department of Anaesthesia, District Headquarter Hospital, Faisalabad. Period: The data was collected duringthe last three and a half years. Materials and Methods: Sixty adult patients of either sex and ages ranging from 35-45years, who underwent lower abdominal surgery, were randomly selected for the study. They were equally divided intotwo groups. Group I patients were administered Buprenorphine 0.3 mg through the epidural catheter in extraduralspace. Group II patients were given Buprenorphine 0.3 mg intramuscularly. Results: Buprenorphine through theepidural route gives better analgesia with fewer side effects as compared with the parenteral route.

Acute Pain Management and Tissue Pain

2017 ◽  
Author(s):  
Ignacio Badiola
Keyword(s):  
Pain Management ◽  
Acute Pain ◽  
Pain Treatment ◽  
Pain Medicine ◽  
Acute Pain Management ◽  
Certification Exam ◽  
Adults And Children

This chapter on acute pain medicine examines the themes represented on the American Board of Anesthesiology’s pain medicine certification exam. It covers Part 6 (tissue pain), Section 1 (acute pain). In detail, the epidemiology of acute pain, current inadequacy of acute pain therapies, the physiology of acute pain, and both pharmacologic and nonpharmacologic aspects of acute pain treatment are discussed. Tools for assessing acute pain are reviewed, as well as the roles of both patient and family as they relate to adults and children in acute pain.

scholarly journals Acute and Chronic Pain Learning and Teaching in Medical School—An Observational Cross-Sectional Study Regarding Preparation and Self-Confidence of Clinical and Pre-Clinical Medical Students

Medicina ◽  
2019 ◽  
Vol 55 (9) ◽  
pp. 533 ◽  
Author(s):  
Kacper Lechowicz ◽  
Igor Karolak ◽  
Sylwester Drożdżal ◽  
Maciej Żukowski ◽  
Aleksandra Szylińska ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Medical Students ◽  
Acute Pain ◽  
Pain Treatment ◽  
Cross Sectional Study ◽  
Clinical Group ◽  
Sectional Study ◽  
Cross Sectional ◽  
Actual Knowledge

Background and objectives: Adequate pain management is a major challenge of public health. The majority of students graduating from medical schools has insufficient education and experience with patients suffering pain. Not enough is being taught regarding pain in non-verbal patients (children, critically ill in the intensive care unit, demented). Chronic pain is the most difficult to optimize and requires appropriate preparation at the level of medical school. Our aim was to evaluate attitudes, expectations and the actual knowledge of medical students at different levels of their career path regarding the assessment and treatment of acute and chronic pain. Materials and Methods: We performed an observational cross-sectional study that was based on a survey distributed among medical students of pre-clinical and post-clinical years at the Pomeranian Medical University in Szczecin, Poland. The survey included: demographic data, number of hours of formal pain teaching, actual knowledge of pain assessment, and pain treatment options in adults and children. Results: We received responses from 77/364 (21.15%) students and 79.2% of them rated the need to obtain knowledge regarding pain as very important (10/10 points). Post-clinical group declared having on average 11.51 h of acute pain teaching as compared to the 7.4 h reported by the pre-clinical group (p = 0.012). Graduating students also reported having significantly more classes regarding the treatment of chronic pain (6.08 h vs. 3.79 h, p = 0.007). The average level of comfort in the post-clinical group regarding treatment of acute pain was higher than in the pre-clinical group (6.05 vs. 4.26, p = 0.006), similarly with chronic pain treatment in adults (4.33 vs. 2.97, p = 0.021) and with pain treatment in children (3.14 vs. 1.97, p = 0.026). Conclusions: This study shows that education about pain management is a priority to medical students. Despite this, there continues to be a discrepancy between students’ expectations and the actual teaching and knowledge regarding effective pain management, including the vulnerable groups: chronic pain patients, children, and critically ill people.

scholarly journals Acute Pain Assessment Inadequacy in the Emergency Department: Patients’ Perspective

2022 ◽  
Vol 9 ◽  
pp. 237437352110496
Author(s):  
Jenni Hämäläinen ◽  
Tarja Kvist ◽  
Päivi Kankkunen
Keyword(s):  
Emergency Department ◽  
Pain Management ◽  
Acute Pain ◽  
Pain Assessment ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Numerical Rating ◽  
Emergency Department Patients ◽  
Pain At Rest ◽  
Patients Perspective

For many patients, acute pain is a common cause to seek treatment in an Emergency Department (ED). An inadequate assessment could cause inappropriate pain management. The aim of this study was to describe and explain patients’ perceptions of acute pain assessment in the Emergency Department. The data were collected from ED patients (n = 114). Patients reported that nurses were asking about intensity of pain at rest, but only 52% during movement. According to the patients, the most common tools to assess acute pain were the verbal rating scale (VRS; 54% of patients), numerical rating scale (NRS; 28% of patients), and visual analogue scale (VAS; 9.7% of patients). Over twenty per cent of patients stated that ED nurses did not ask about the intensity of pain after analgesic administration. Twenty-four per cent of the patients were not pleased with nursing pain assessment in the ED. The assessment of acute pain is still inadequate in the ED. Therefore, ED nurses need to be more attentive to systematic acute pain management of patients in the ED.

scholarly journals Bringing It All Together: A Review of the Challenges in Measuring Children’s Satisfaction as a Key Component of Acute Pain Management

Children ◽  
2020 ◽  
Vol 7 (11) ◽  
pp. 243
Author(s):  
Joseph W. Hodapp ◽  
Samina Ali ◽  
Amy L. Drendel
Keyword(s):  
Pain Management ◽  
Acute Pain ◽  
Pediatric Patients ◽  
Consensus Statement ◽  
Pain Treatment ◽  
Developmentally Appropriate ◽  
Future Research ◽  
Decision Making Process ◽  
Acute Pain Management ◽  
Self Evaluation

In 2008, the Pediatric Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (PedIMMPACT) published a consensus statement that recognized the dearth of research surrounding the topic of children’s satisfaction with acute pain management. This review of published literature will summarize what is known about the topic of children’s satisfaction with pain management, identify current gaps in the knowledge, and provide direction for future research in this critical area. Including children in the decision-making process as soon as they are developmentally able is a concept that is the fundamental basis for seeking assent and more active roles within healthcare decisions for children. It is the responsibility of adults to provide them with increasing opportunities for self-evaluation and more independent management of their healthcare, encouraging the development of children into adults. As clinicians and researchers, it is our prerogative to support the maturation of children by building effective methods to communicate their satisfaction with acute pain treatment and healthcare. Children’s satisfaction with acute pain management is not well studied and further research is needed for the development of inclusive, developmentally appropriate measures of satisfaction for our pediatric patients.

scholarly journals A multicentre survey of pain management in cancer patients and physicians attending radiotherapy clinics in Shandong Province, China

2019 ◽  
Vol 47 (11) ◽  
pp. 5711-5722
Author(s):  
Bingxu Tan ◽  
Baosheng Li ◽  
Yongheng An ◽  
Xuezhen Ma ◽  
Yuhua Jiang ◽  
...  
Keyword(s):  
Pain Management ◽  
Pain Treatment ◽  
Cross Sectional Study ◽  
Shandong Province ◽  
Cross Sectional ◽  
Waiting Period ◽  
Face To Face ◽  
Significant Difference ◽  
High Incidence ◽  
Prevalence Of Pain

Objective To obtain a better understanding of the prevalence and management of pain in patients undergoing radiotherapy for cancer in Shandong Province, China. Methods This cross-sectional study used a questionnaire during face-to-face interviews to collect data from physicians and patients regarding the recognition, prevalence and treatment of pain during the waiting period before commencement of radiotherapy and during the radiotherapy period. Physicians and patients were recruited from 10 tertiary Class A hospitals across Shandong Province, China. Results A total of 184 patients and 87 physicians were recruited to the study. During the waiting period, pain was reported by the physicians according to their experience to affect 26.0% of patients, which almost agreed with the patients’ data (36.5%; 160 of 438). During the radiotherapy period, there was a significant difference in the reported prevalence of pain during the radiotherapy period between the physicians’ data (23.0%) based on their experience and the patients’ data (84.1%; 169 of 201 patients). The majority of physicians (98.9%; 86 of 87) agreed to the use opioids for pain management and 90.8% (79 of 87) were satisfied with the analgesic effect, but more than half of the patients who received pain treatment reported inadequate analgesia. Conclusion There was a high incidence of cancer pain, but insufficient assessment, inadequate treatment and inadequate education about pain in both the waiting and radiotherapy periods.

Effect of intraoperative nefopam on acute pain management after major abdominal surgery

2012 ◽  
Vol 29 ◽  
pp. 204
Author(s):  
I. Cindea ◽  
A. Balcan ◽  
V. Gherghina ◽  
B. Samoila ◽  
G. Nicolae ◽  
...  
Keyword(s):  
Pain Management ◽  
Abdominal Surgery ◽  
Acute Pain ◽  
Major Abdominal Surgery ◽  
Acute Pain Management

scholarly journals GUDA VARTI FOR POST-OPERATIVE PAIN MANAGEMENT- ROAD LESS TRAVELLED

2021 ◽  
pp. 90-93
Author(s):  
Vilas Thakre Kalpita ◽  
P Bhat Ramesh
Keyword(s):  
Drug Delivery ◽  
Pain Management ◽  
Drug Delivery System ◽  
Acute Pain ◽  
Full Potential ◽  
Psychological Response ◽  
Post Operative Pain ◽  
Wide Range ◽  
Almost All ◽  
Adequate Management

Acute pain is an unpleasant sensory, emotional and mental sensation (experience) associated with vegetative signs, psychological response and changes in behavior. Post-operative pain is one such example and adequate management becomes utmost necessary. In Shalya tantra practice, proctology is the field of excellence for many practitioners and post-operative pain is an acquaintance difficult to handle. Many practitioners still resort to using contemporary I.M OR I.V analgesics for pain management which have proven ADR’S due to lack of availability of Ayurvedic analgesics for management. Vartis (suppositories) was in vogue since pre-historic times and have been mentioned in almost all Ayurvedic texts for various disorders with suitable formulations and various modes of insertion, e.g.: Ratadi varti for Shoola. Ayurveda also has a wide-range of drugs mentioned for relieving pain which have not been used to the full potential. Hence Guda varti as a drug delivery system for pain management needs to be explored in Ayurveda Shalya tantra practice.

scholarly journals The pain in the Emergency Department: Choosing and treating wisely before and during the COVID-19 era

2021 ◽  
Vol 17 (4) ◽  
Author(s):  
Erika Poggiali ◽  
Fabio De Iaco
Keyword(s):  
Emergency Department ◽  
Pain Management ◽  
Acute Pain ◽  
The Elderly ◽  
Point Of View ◽  
Post Traumatic Stress ◽  
Post Traumatic ◽  
The Right ◽  
Anxiety Depression ◽  
Adequate Management

Pain is a frequent reason for referral to the Emergency Department (ED). Adequate management of pain is a moral and ethical imperative. If not correctly treated, acute pain can cause physical and psychological complications, and become chronic with severe consequences such as anxiety, depression, and social isolation. As consequence, emergency clinicians should treat pain as soon as possible, avoiding delays even in case of acute abdominal pain. Pain management is particularly complex in the elderly and emergency clinicians should always consider AGS Beers criteria ® to avoid inappropriate medications, severe side-effects, and drug-drug interactions. Pain is also a common cause of delirium in older patients. The SARS CoV-2 infection not only can cause acute pain, but also exacerbate chronic pain, particularly in the elderly, who are at high risk to be infected. Looking at all this evidence, emergency clinicians should treat pain with different strategies according to their experience and cultural background, making the right choice for each patient. This work is a critical review of the pain management in the ED, with a particular attention on the effects of COVID-19 in the EDs. We conducted a systematic search of the following databases: PubMed, Google Scholar, Science Direct, Medline from 2000 to 2020, using the keywords of “pain”, “emergency”, “COVID19”, “elderly”, “palliative care”, “ketamine”, “dexmedetomidine”, and “post-traumatic stress disorder”. The aim of this review is to help emergency clinicians to correctly manage pain in the ED with a new point of view regarding the pain management in COVID-19 patients.

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