Does an Acute Pain Service Improve Postoperative Outcome?

Efficacy and Safety of an Acute Pain Service among 10,760 Postoperative Patients

“…The need to create a "hospital without pain" is connected to multiple reasons: first of all, pain is probably one of the most disturbing experiences and its treatment is a moral and ethical imperative; furthermore, a painless patient is able to breathe easier, cough efficiently and move sooner; as a direct consequence he/she is less subject to cardiovascular complications, pulmonary infections and thromboembolic events, and definitively presents a better postoperative outcome. (5)(6)(7)(8) Patient-controlled analgesia (PCA) and continuous epidural analgesia are associated with a reduction in postoperative morbidity in defined categories of patients and surgeries. (8) However, these specialized techniques can be associated with serious neurologic, cardiovascular and respiratory complications if used in general wards without particular precautions.…”

“…(5)(6)(7)(8) Patient-controlled analgesia (PCA) and continuous epidural analgesia are associated with a reduction in postoperative morbidity in defined categories of patients and surgeries. (8) However, these specialized techniques can be associated with serious neurologic, cardiovascular and respiratory complications if used in general wards without particular precautions. (5,9) Acute Pain Services (APS) have been instituted in many hospitals to achieve effectiveness and safety of postoperative pain management.…”

“…A winning strategy is to create a multidisciplinary team involving surgeons, nurses and anesthetists, where the latter assume a leading role thanks to their specific skills. (7,8,10) The APS team usually defines protocols to prevent pain in different types of surgery, taking into account the characteristics of specific categories of patients (e.g. the elderly).…”

Eficacia analgésica de una dosis única de dexametasona perineural en el bloqueo ecoguiado del nervio femoral en cirugía de prótesis total de rodilla

“…El control eficaz y activo del dolor postoperatorio se ha convertido en una parte esencial de los cuidados perioperatorios y una prioridad médico quirúrgica, ya que existe una fuerte evidencia [46][47][48] de que su adecuado control, junto a otros factores como la movilización y la nutrición precoces, no sólo aumentan el confort y la satisfacción de los pacientes, sino que además contribuyen a disminuir la morbi-mortalidad postoperatoria, estando su escaso control directamente relacionado con un aumento en la incidencia de trombosis venosa profunda, tromboembolismo pulmonar, infarto agudo de miocardio, neumonía, mala cicatrización de las heridas, insomnio y malestar del paciente [49][50][51] .…”

Dental note: Postoperative pain management

“…14 Ideally, multimodal procedure-specific analgesia should be incorporated into a rehabilitation program after surgery to improve patient outcomes. [31][32][33][34] Guidelines for procedure-specific analgesia are available online. 35,36 Discharge planning Pain management for day surgery patients remains the responsibility of the anaesthetist or the surgeon.…”