Summary
Nurse-administered analgesia is simple, universally accessible, and cost-effective. This route of administration must be fully explored and exploited to gain maximal analgesia at minimal cost. Combined, balanced multimodal analgesia with NSAIDs and opioids used preoperatively to prevent pain should be encouraged. Intraoperative analgesia should not consist solely of opioids, but also local anaesthetics and NSAIDs. Postoperatively, balanced analgesia should continue and when the patient is able to tolerate fluids the oral route of administration should be used. The solution to improved postoperative analgesia lies in exploitation and liberalization of traditional analgesic drugs and techniques. We do not need new pharmacology or new technology. We need to use the drugs and techniques we already have in a much more effective and efficient fashion.
Résumé
L’administration d’analgésiques par le personnel infirmier est simple, accessible à tous et sans coûts exagérés. Ce régime d’administration doit être ré-étudié en profondeur et appliquée en vue d’une analgésie idéal au meilleur coût possible. Une analgésie équilibrée, polymorphe avec AINS et opiacés devrait être utilisée préventivement à la période préopératoire. L’analgésie peropératoire ne doit pas reposer uniquement sur les opiacés, mais aussi sur les anesthésiques locaux et les AINS. A la période postopératoire, I’analgésie équilibrée doit être continuée et dès que le patient tolère l’ingestion de liquides, on doit recourir à l’administration orale. L’amélioration de l’analgésie postopératoire réside dans la libéralisation et l’exploitation rationnelle des drogues et techniques traditionnelles. Il nous faut utiliser plus efficacement les agents disponibles.
Avec l’analgésie épidurale et intraveineuse autocontrôlée appliquées aux interventions lourdes, les anesthésistes sont à l’avant-garde. A l’intérieur de nos institutions, nous devons rendre le traitement optimal de la douleur postopératoire accessible à tous. L’approche multidisciplinaire et l’accès à un éventail approprié d’analgésiques sont essentiels, ce qui représente une évolution de la pratique habituelle. On a dépense beaucoup de temps et d’énergie pour l’élaboration de nouvelles recommandations et elles mérient notre considération dans l’optique traitement présente et futur de la douleur postopératoire.
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Moote, C. Techniques for post-op pain management in the adult. Can J Anaesth 40 (Suppl 1), R19–R28 (1993). https://doi.org/10.1007/BF03020682
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DOI: https://doi.org/10.1007/BF03020682