The activity of an acute pain service in a teaching hospital: Five years experience

Summary 

Background

Pain is an integral part of the post-operative recovery process, and ineffective pain management is common. In order to improve treatment of post-operative pain, we have established an acute pain service (APS). The APS team is responsible for the follow up of all surgical patients who are treated post-operatively with continuous epidural (CE) or intravenous patient-controlled analgesia (IV PCA). These relatively new analgesic techniques enable us to provide better analgesia following intermediate and major surgery.

Purpose

To retrospectively review the extent of CE and IV PCA use in three surgical departments since 1999, during that time period the APS was implemented and working.

Methods

We reviewed data on patients from the Departments of Gynecology, Thoracic Surgery and General Surgery undergoing specific surgical procedures during the first three months of each year from 1999 until 2003. For each surgical procedure, we also identified the number of patients whose pain was controlled by either CE or IV PCA analgesia, as well as recording the duration of analgesic therapy using the two methods.

Results

We observed progressive increases in the number and rate of patients treated by either CE or IV PCA and the number of analgesic treatment days without a significant change in the number of operations in the three surgical departments.

Conclusions

The introduction of APS led to an increase in medical staff's awareness of patient pain and use of new analgesic techniques (CE and IV PCA). This study validates the importance of APS in improving post-operative pain management.

Keywords: Pain, Epidural, Analgesia, Acute pain service