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An acute pain service in an Australian teaching hospital: the first year
Author(s) -
Macintyre Pamela E,
Runciman William B,
Webb Robert K
Publication year - 1990
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.1990.tb125503.x
Subject(s) - medicine , nausea , vomiting , antiemetic , anesthesia , opioid , depression (economics) , receptor , economics , macroeconomics
The Acute Pain Service began at the Royal Adelaide Hospital in April 1989. Funding, education programmes, policies, procedures, protocols, techniques (particularly patient‐controlled analgesia, epidural opioid analgesia and subcutaneous morphine therapy) and daily organisation of the service are described in this article, and the experience with the 1053 patients referred to the Service during the first year of operation is reported. The occurrence of major complications was small. Mild‐to‐moderate respiratory depression occurred in four (0.5%) of the 747 patients who received patient‐controlled analgesia and in none of the 177 who received epidural opioids. Five patients receiving patient‐controlled analgesia had persistent nausea/vomiting; 320 (35%) of all patients receiving patientcontrolled analgesia or epidural opioids suffered nausea/vomiting that required no treatment or was alleviated by treatment with an antiemetic. Around 13% of patients reported mild‐to‐moderate itching. In our experience, the combination of appropriately trained nursing and medical staff, standardised orders and procedures, and proper supervision can lead to safe, more effective management of acute pain.