Anestéziológia a intenzívna medicína 1/2012

Postoperative pain management in Slovak Republic

Every year approximately 300 000 anesthesias are performed for diagnostic, therapeutic and mainly surgical procedures in Slovak Republic. Therefore we have to ask the question how is the patient’s right for pain-control managed. In 2008 and 2011 we performed two cross-sectional studies of pain management in selected hospitals in Slovakia. From these studies it is obvious that the patient’s rights for pain management are not met sufficiently. There has been some positive progress in postoperative pain management in recent years, but inappropriate methods of pain management are still utilized, stereotypes are repeated, there is insufficient communication with the patients, documentation is inadequate or the problem of acute pain management is not taken seriously. Pain is perceived as a phenomenon that will disappear on its own. In many hospitals pain management guidelines are lacking and responsibility for pain management is not designated properly. Postoperative pain management should not only fulfill healthcare purposes, but should also be focused on ethical and economical aspects of pain management. Untreated or insufficiently treated postoperative pain can have legal consequences. Unlike other sensory perception, pain is a very subjective perception, which is very hard to objectively quantify. There is a substantial psychophysiological interaction between the perception and transmission of pain on one hand and cognitive and affective processing of the information on the other. Untreated and persisting pain leads to psychogenic morbidity, anxiety, depression and despair. Early postoperative pain management can prevent such complications. During therapy we have the option to use multimodal analgesic regimens in logical order with overlapping analgesic effects to achieve sufficient pain control. The goal of this work is to give us the overview of the main drug classes being used, some specific drugs utilized, the possibilities of combined drug therapy and the proposition of establishing an acute pain management service.

Keywords: pain analgesia, analgesics, acute pain management service.