Interventions: Benefits and Barriers
Benefits of Good Acute Pain Management Effective prevention or relief of acute pain is cost-effective. Table 1 lists some of the benefits that accrue to institutions that achieve good pain control. There are no compelling reasons to defend the gap that exists between existing knowledge and technology for acute pain control and current practice patterns. Table 1: Benefits of effective acute pain management for institutions Earlier discharge from intensive care unit or hospital Lower use of health care resources Fewer complications that require physician time and health care resources More efficient use of nursing resources and time Better patient satisfaction with the hospital, stronger marketing, improved hospital reputation Reduced costs to insurance providers or other payers Fewer acute pain patients developing chronic pain syndromes from their persistent acute pain Fewer days of disability and lost work productivity
Interventions for Acute Pain Regional anesthesia targets noxious signaling, anti-inflammatory medications target inflammation and related sensitization, and spinal medications target central sensitization. Opioids target endogenous pain modulation processes. Other agents such as anticonvulsants influence acute pain by diverse mechanisms. In postoperative settings, many acute pain management specialists combine several interventions for “multimodal analgesia.” Table 2 lists interventions for postoperative and other acute pain control. Table 2: Interventions for acute pain prevention and relief Preoperative Setup and Treatments for Surgery and Procedures Patient information and empowerment Minimally invasive techniques, adequate positioning of patients in the operating room Medication or nerve blocks prior to surgical incision Systemic Analgesics Opioids and intravenous patient controlled analgesia (PCA) Nonsteroidal anti-inflammatory drugs (NSAIDs) Ketamine and other agents directed at excitatory amino acids...
References:  Benhamou D, Berti M, Brodner G, De Andres J, Draisci G, Moreno-Azcoita M, Neugebauer EA, Schwenk W, Torres LM, Viel E. Postoperative Analgesic THerapy Observational Survey (PATHOS): a practice pattern study in 7 Central/Southern European countries. Pain 2008;136:134–41.  Neugebauer E, Hempel K, Sauerland S, Lempa M, Koch G. [The status of perioperative treatment of pain in Germany. Results of a representative and anonymous survey of 1,000 surgical clinics. Chirurg 1998;69:461–6.
© 2010 International Association for the Study of Pain
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