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Query: UMLS:C0184567 (acute pain)
 3,962 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This three-year study investigated the experience of postoperative pain and its management following elective surgery in an adolescent population aged 12-18 years (n=351) in 5 NHS trusts. In addition to the adolescents, one parent of each adolescent and a range of health professionals including surgeons, anaesthetists and registered nurses were interviewed concerning their views on acute pain in adolescent patients. The results presented in this paper are those related to the management of day and inpatient surgery in this adolescent population. Data were collected pre-operatively and postoperatively (days 1 and 3) using semi-structured interviews, telephone interviews, self-completion questionnaires and standardised tools to measure pain intensity (Adolescent Pediatric Pain Tool), psychological adjustment to adolescence (Offer Self-Image Questionnaire-Revised) and emotional state (Hospital Anxiety and Depression Scale). Day cases were discharged on the day of surgery while most inpatients were discharged on the first postoperative day.
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PMID:Postoperative pain: a comparison of adolescent inpatient and day patient experiences. 1124 69

Following the establishment of an acute pain service in one UK acute NHS trust, including the introduction of patient-controlled analgesia (PCA), pain scoring, and a rationalization of the use of simple analgesics, attention was drawn to an apparent increase in postoperative nausea and vomiting (PONV) among women given PCA following abdominal hysterectomy. Audits were conducted into clinical practice and patient satisfaction and it was agreed that an evaluation of the evidence should be conducted to ensure that the correct direction for development in the management of PONV could be established. This article discusses the evidence surrounding the issues regarding the management of PONV in patients who have been given PCA. The possibility of adding antiemetics to the analgesic solution, and the choice of antiemetic drugs, are investigated. Other factors that can affect the incidence of PONV in patients with PCA are also discussed, and an auditable framework for the evaluation of clinically effective practice is suggested.
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PMID:Postoperative nausea management and patient-controlled analgesia. 1197 21

To describe facilities for postoperative epidurals in UK National Health Service Hospitals, a questionnaire was sent to each hospital performing surgery below the head and neck. Of 271 hospitals, 256 replied (95%). While almost all offer postoperative epidurals, only 78 (30%) offer them to all surgical disciplines. Most hospitals rely on acute pain nurses for troubleshooting during the day, and on trainee anaesthetists after hours. Administration is most commonly by continuous infusion. There was no restriction on the use of epidural opioids in 67% of hospitals. Most (96%) hospitals have a protocol for epidural care, although the specified level of monitoring varies widely. There is no consensus of practice on removal of epidural catheters relative to anticoagulation. Levels of training in epidural care also vary widely. Two hundred and thirty-six hospitals (92%) have an acute pain team. Despite the expansion in acute pain services, facilities for postoperative epidurals are deficient in many NHS hospitals.
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PMID:Provision of postoperative epidural services in NHS hospitals. 1213 91

Continual epidural infusions are an accepted intervention for the management of postoperative pain (McQuay and Moore 1998). Benchmarking nationally through an unpublished audit of Pain Society members identified variation in the concentrations prescribed and delivery systems used. These differences were reflected in local practice. As a result of the local disparity in the management and provision of epidural infusions, the acute pain service at Southampton University Hospitals NHS Trust worked in conjunction with the pharmacy department to standardise the service provided to patients and staff. This process was complicated by the difficulty in obtaining anaesthetist consensus for a standard solution that was commercially available and funding for the dedicated delivery system.
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PMID:Using clinical governance to standardise an epidural service. 1464 93

There is a strong research base to support the value and importance of acute pain management. There have been significant improvements in this specialty in the NHS since the introduction of acute pain teams in the early 1990s. The Armed Forces have embraced the concept more recently, and are making progress in this valuable area. This article examines the role of an acute pain specialist nurse in the Royal Navy and the importance of high quality, evidence-based pain management in the Armed Forces. The value of a military specialist nurse working as an integral part of a large NHS trust and how that relates to an operational role in the Royal Navy is also explored. The article draws conclusions about the importance of retaining senior specialist nurses in the clinical setting in order to ensure that the Armed Forces have access to up-to-date clinical expertise, especially when medical staff are deployed in operational roles.
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PMID:Exploring the role of an acute pain specialist nurse in the Royal Navy. 1579 6