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Acute Pain Service: A 10‐Year Experience
Author(s) -
Deni Francesco,
Greco Massimiliano,
Turi Stefano,
Meani Renato,
Comotti Laura,
Perotti Valeria,
Mello Alessandra,
Colnaghi Eleonora,
Pasculli Nicola,
Nardelli Pasquale,
Landoni Giovanni,
Beretta Luigi
Publication year - 2019
Publication title -
pain practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 58
eISSN - 1533-2500
pISSN - 1530-7085
DOI - 10.1111/papr.12777
Subject(s) - medicine , service (business) , acute pain , medical emergency , physical therapy , emergency medicine , anesthesia , marketing , business
Background Pain management after surgery is crucial to decrease perioperative morbidity and mortality. Acute pain services ( APS ) are multidisciplinary teams that represent a modern strategy to address pain inside hospitals. The APS defines and applies pain treatment protocols specific for each surgery. To evaluate the performance of the APS at our institute, we performed a large retrospective cohort study focusing on complications of epidural analgesia and IV opiates. Methods Data from the 10 years of activity of the APS were collected. Pain was assessed using the VAS at rest ( VAS r) and during movement ( VAS m) at each daily visit; the presence of side effects and complications was also assessed. Results A total of 17,913 adult patients were followed by APS during the study period. Epidural analgesia was used in 7,776 cases (43%), while 9,239 (52%) patients used IV patient‐controlled analgesia ( PCA ). A combination of the 2 was used in 87 patients (0.5%). A total of 456 perineural catheters (2.6%) were placed, while 442 patients(2.5%) used other analgesic techniques. We recorded 163 dural punctures during catheter placement, with no epidural hematoma, epidural abscess, or meningitis, and no permanent modification in sensitive or motor functions. Conclusions In our large case series, APS was confirmed safe and effective in treating postoperative pain, using both epidural analgesia and IV PCA with morphine.