Paliatívna medicína a liečba bolesti 2/2011

Acute pain service – postoperative pain, need and possibilities of control, management

Acute pain service (APS) need the interdisciplinary team: pain specialist as guarantee of methodology and safety, pain nurses, who make daily control of patients, monitoring of pain relief and side effects in close cooperation with pain specialist and anaesthetists, surgeons and nurses of ICU. On-going education of all participants is essential. Postoperative pain management is different according to the kind of surgery and intesity of pain, it takes advantage of methods of „high technology“, „low technology“ and basic pain medicine. Efficacy and safety are outcomes of daily monitoring and reassessment either relief of pain and side effects. Authors give particular attention to the prospective study of 485 patients, treated during years 2004–8 with continual epidural analgesia (CEA). It is the method of choice in major thoracic and abdominal surgery. Their epidural drug´s combination: 0,5 % bupivacaine 10 ml, morphine 5 mg, epinephrine 50 ug, natrii isotonici to 50 ml and basal analgesia: metamisol 3 g/die or paracetamol 3 g/die i.v. has sparing effect, decreases the effective doses of epidural morphine and bupivacaine, improves postoperative analgesia and decreases incidence of side effects.

Keywords: acute postoperative pain, possibilities of pain control, service of acute pain.