Acute postoperative pain in adults and children is a well-recognized inherent consequence of tissue damage no matter how minor the procedure or trauma might be. Considerable efforts have been made in recent years to standardize and improve acute pain management through the establishment of guidelines. Historically, management of acute pain has been undervalued for a variety of reasons, including a lack of adequate training. A recent nationwide survey from Sweden demonstrated that a large proportion of children had poor pain relief after surgical procedures (23%) and from nonsurgical conditions (31%) due mainly to organizational deficiencies rather than knowledge deficiency or lack of time or other burdens on health care providers. The Joint Commission and other organizations have mandated systematic pain assessment, informing patients of their right to pain relief, prompt and effective treatment of unrelieved pain, access to specialists in pain management, and hospital-wide efforts at continuous quality improvement in pain treatment. These initiatives develop a set of pain protocols specifically for pediatric care, foster combined use of nonpharmacologic and pharmacologic approaches, and promote collaboration of multiple disciplines to manage a child's anxiety and fear as well as pain. These goals are best achieved through implementation of an acute pain management consult service to provide 24-hour consultation and supervise and administer analgesics requiring specialized interventions, such as epidural analgesia, continuous peripheral nerve blocks (PNBs), or complex pharmacologic management. Such a service is usually staffed by anesthesiologists, anesthesia trainees, and trained nurses.
|Original language||English (US)|
|Title of host publication||Essential Clinical Anesthesia|
|Publisher||Cambridge University Press|
|Number of pages||9|
|State||Published - Jan 1 2011|
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