American Society for Pain Management Nursing Position Statement

Oliver, June E.; Coggins, Candace; Compton, Peggy; Hagan, Susan; Matteliano, Deborah; Stanton, Marsha; Marie, Barbara St.; Strobbe, Stephen; Turner, Helen

doi:10.1097/jan.0b013e318271c123

Cited by 26 publications

(6 citation statements)

References 50 publications

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“…17 However, specifically for drug abuse patients, these newer potential treatment options should be coupled with risk stratification, as well as a more holistic and life-style altering approach to pain management. 18–20…”

Section: Discussionmentioning

confidence: 99%

Incidence of Drug Abuse in Revision Total Knee Arthroplasty Population

et al. 2018

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Substance abuse can have strong negative impacts on surgical outcomes. Therefore, this study assessed the effects of drug abuse in total knee arthroplasty (TKA) patients. Specifically, we identified revision TKA (RTKA): (1) incidence, (2) causes, (3) time to revision, and (4) patient demographics in patients with a history of drug abuse. The Medicare database within the PearlDiver Supercomputer (Warsaw, IN) was queried to identify 2,159,221 TKAs performed between 2005 and 2012. Drug abuse was subdivided into cocaine, cannabis, opioids, sedatives/hypnotics/anxiolytics (SHA), amphetamines, and alcohol abusers. The effect of drug use on the incidence and cause for RTKA, time to revision, as well as patient demographics were correlated using multivariate, analysis of variance, and regression analyses. There was a significant increase in the number of primary TKAs in cocaine ( = 0.011), cannabis ( < 0.001), opioid ( < 0.001), SHA ( < 0.001), amphetamine ( < 0.001), and alcohol ( < 0.001) users. Amphetamine users had the fastest mean time to revision (691 days, standard deviation: 679 days). At 30-, 90-day, and 6-month postoperative, cocaine had the highest proportion of patients requiring RTKA (7, 12, and 20%, respectively), and at 1-year alcohol abusers (38%, < 0.001). Infection was the most common cause of revision in all drug abuse/dependent cohorts. Age distributions varied significantly by group for primary TKA ( < 0.001). Comorbidity status was similar in all RTKA patients as determined by comparison of the mean Charlson comorbidity index scores ( = 0.091). Based on these results, drug abuse patients are at increased risk for RTKA. These high-risk patients should, therefore, be appropriately risk stratified and receive comprehensive postoperative pain management.

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Section: Discussionmentioning

confidence: 99%

Incidence of Drug Abuse in Revision Total Knee Arthroplasty Population

et al. 2018

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“…Conversely, due to the potential stress induced, unrelieved pain is a risk factor for relapse among the addicted patients. 35 , 36 Additional opioids for analgesia may cause respiratory and CNS depression. Clinical experience does not support this concern.…”

Section: Prejudice and Misconceptions That Limit Postoperative Pain Tmentioning

confidence: 99%

“…Conversely, due to the potential stress induced, unrelieved pain is a risk factor for relapse among the addicted patients. 35 , 36 …”

Section: Prejudice and Misconceptions That Limit Postoperative Pain Tmentioning

confidence: 99%

The challenge of perioperative pain management in opioid-tolerant patients

Coluzzi¹,

Bifulco²,

Cuomo³

et al. 2017

TCRM

117

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The increasing number of opioid users among chronic pain patients, and opioid abusers among the general population, makes perioperative pain management challenging for health care professionals. Anesthesiologists, surgeons, and nurses should be familiar with some pharmacological phenomena which are typical of opioid users and abusers, such as tolerance, physical dependence, hyperalgesia, and addiction. Inadequate pain management is very common in these patients, due to common prejudices and fears. The target of preoperative evaluation is to identify comorbidities and risk factors and recognize signs and symptoms of opioid abuse and opioid withdrawal. Clinicians are encouraged to plan perioperative pain medications and to refer these patients to psychiatrists and addiction specialists for their evaluation. The aim of this review was to give practical suggestions for perioperative management of surgical opioid-tolerant patients, together with schemes of opioid conversion for chronic pain patients assuming oral or transdermal opioids, and patients under maintenance programs with methadone, buprenorphine, or naltrexone.

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“…Although most nurses accept the use of analgesics to control patient pain, they tend to use fewer analgesics for fear of side effects and addiction [6]. In Korea, 50 to 80% of cancer patients do not receive proper pain treatment due to passive attitudes toward and perceptions of pain management [7]. Also, the World Health Organization (WHO) marked Korea as moderate level in the adequacy of opioid analgesic consumption, because the use of analgesics in Korea showed 47.0% in the adequacy of consumption measure (ACM) comparing the country with the highest ACM value (Canada; 312.6%) [8].…”

Section: Introductionmentioning

confidence: 99%

“…Nurses' assessment of and intervention in pain plays an essential role in effective pain control for patients [11]. However, previous studies have focused on the knowledge and attitudes of patients [5] and medical staff as factors affecting self-reporting and pain evaluation [7]. There are insufficient case studies on the evaluation of pain intensity according to patients' facial expressions or the investigation of pain management.…”

Section: Introductionmentioning

confidence: 99%

Differences in nurses’ perceptions of self-reported pain and the administered morphine dose according to the patient’s facial expression in Korea

Park

Lee

2020

J Educ Eval Health Prof

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Purpose: This study aimed to compare the nurses’ perception, recording, and treatment of the patient’s self-reported pain according to the patient facial expression.Methods: It is a descriptive cross-sectional survey. Participants were 482 nurses working at a tertiary hospital in Seoul, Korea. The self-reporting questionnaire required nurses to answer the pain intensity, records, and medication for a smiling patient complaining of acute post-surgical pain and a grimacing cancer-pain patient.Results: The pain intensity perceived by nurses in grimacing patients was significantly higher than that for smiling patients (P < 0.001). The score of pain recording was significantly higher for grimacing patients than for smiling patients (P < 0.001). There was a significant difference in the amount of morphine chosen by the nurses for pain intervention in smiling and grimacing patients (P=0.040). Higher perceived pain intensities and scores reflected in the pain record resulted in greater administered doses of morphine.Conclusion: These findings suggest that the nurses might be affected by a patient’s facial expression when treating pain. A pain-management program should be developed that enables nurses to accurately recognize pain hidden in patients’ faces and provides them with the knowledge of how to appropriately assess and manage patients’ pain.

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American Society for Pain Management Nursing Position Statement

Cited by 26 publications

References 50 publications

Incidence of Drug Abuse in Revision Total Knee Arthroplasty Population

Incidence of Drug Abuse in Revision Total Knee Arthroplasty Population

The challenge of perioperative pain management in opioid-tolerant patients

Differences in nurses’ perceptions of self-reported pain and the administered morphine dose according to the patient’s facial expression in Korea

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