Organization of Postoperative Pain Service
In spite of unprecedented interest in postoperative pain and its management, most patients undergoing surgery do not receive adequate analgesia on surgical wards. The most common technique for providing postoperative analgesia has been and still is the use of i.m. opioids prescribed by surgeons and administered by ward nurses on an as-needed basis. The inadequacies of this method of pain management are well recognized. It is increasingly clear that if postoperative analgesia has to be improved on surgical wards, techniques such as PCA, epidural analgesia and peripheral nerve blocks have to be introduced on a routine basis. These techniques provide superior analgesia as compared to i.m. opioids but have their own risks and therefore require special monitoring. Traditional methods of analgesia are not risk-free either, but the risks have rarely been quantified. It could be argued that all patients recovering from surgery irrespective of route of opioid delivery should be monitored, particularly patients with poor pain relief. While better postoperative pain is relatively easily achievable, there has to be a balance between acceptable risk, perceived benefit and cost-effectiveness. Without an effective organization of postoperative pain services, pain management on surgical wards will remain unsatisfactory. Furthermore, quality assurance measures such as frequent recording of pain intensity and treatment efficacy can no longer be ignored.
KeywordsPain Management Postoperative Analgesia Surgical Ward Postoperative Pain Relief Postoperative Pain Management
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