Acute Pain after Surgery: Lessons Learned from the Last Decade

Slides:



Advertisements
Similar presentations
Implementing NICE guidance
Advertisements

UCSF Perspective: Improving pain management education and care while reducing the opioid burden Mark Schumacher Ph.D., M.D. Professor and Chief, Division.
Reducing hospital costs with Acute Pain Service? Anna Lee Department of Anaesthesia and Intensive Care The Chinese University of Hong Kong
A systematic review of the analgesic efficacy and adverse effects of epidural morphine versus parenteral morphine after caesarean section Carmen KM Chan.
Evidence Based Medicine in Peri-operative Care Wimonrat Sriraj M.D. Department of Anesthesiology, Faculty of Medicine, Khon Kaen University Phuket17/07/2008.
The Health Roundtable 3-3c_HRT1215-Session_LEMANU_CMDHB_NZ Enhanced Recovery After Laparoscopic Sleeve Gastrectomy: A Randomised Controlled Trial Presenter:
Elective Colorectal Resection – How to Hasten the Recovery? Dr. Lily Ng RHTSK.
TEMPLATE DESIGN © Audit of the Enhanced Recovery Programme for Hysterectomy at West Middlesex University Hospital Background.
Redefining Local Anesthetic
100% Adherence to Guidelines An Expert System for Preoperative Screening.
Prof. Krishna Boddu. MBBS, MD, DNB, FANZCA, MMEd MBBS, MD, DNB, FANZCA, MMEd University of Texas Health Sciences at Houston, Texas, USA University of Western.
Intra-Operative Brain Function Monitors Thomas Jan.
Copyright © 2012, 2011, 2010, 2009, 2008, 2007, 2006, 2005, 2004, 2002 by Saunders, an imprint of Elsevier Inc. Slide 1 CHAPTER 16 ANESTHESIA.
Management of Rib Fractures. Clinical Anatomy 12 pairs of ribs Attach posteriorly to vertebrae Rib 8-12 are “false ribs” Ribs 1-3 are relatively well.
APA Acute Pain Guidelines Richard Howard Great Ormond Street Hospital London.
NON-PHARMACOLOGICAL INTERVENTIONS USED BY PATIENTS AFTER SURGERY. PRELIMINARY FINDINGS, INTERNATIONAL PAIN REGISTRY, PAIN OUT Ana-Maria Iuonuţ¹ ², Ruth.
Analgesia Post Emergency Caesarean Section and Educational Intervention in The Developing World Dr Michelle Gerstman Anaesthesia Registrar Alfred Hospital.
INTRODUCING EVIDENCE-BASED MANAGEMENT OF ACUTE PAIN TO RWANDA: A pilot study Antoine Bahati Kabeza, 1 Martin Nyundo, 1 Andreas Kopf, 2 Ruth Zaslansky,
An Audit of Sub-Tenons block for Squint Surgery in Children Dr Steve Gilbert Queen Margaret Hospital Dunfermline.
Career Night 2012 Desiree Persaud MD FRCPC Program Director Anesthesia Associate Professor University of Ottawa University of Ottawa Anesthesia Residency.
A Comparison of Postoperative Opioid Requirements and Effectiveness in
Department of Surgical Sciences and Integrated Diagnostics (DISC) University of Genoa – IRCCS AOU San Martino IST – Genoa, Italy The.
Intra-wound Vancomycin Powder Significantly Reduces the Risk of Infection in Growth-friendly Surgery John T. Smith, MD Justin Haller, MD Angela Presson,
What is interventional Radiology? By: Amber Smith.
Pain Assessment and Management in Children
Comparison of Side Effects with Extended Release Epidural Morphine and Other Analgesic Modalities K. Colfer, M.S.N., R.N.-B.C., K. Gandhi, M.D., M.P.H.,
Paediatric Postoperative Pain Management Rebecca Finnegan Clinical Nurse Consultant.
Regional Anesthesia and Acute Pain Medicine Fellowship University of California, San Diego.
Mansour Choubsaz MD Kums.ac.ir. chronic postsurgical pain (CPSP), Approximately 40 million surgical procedures take place across North America each year.
A Retrospective Study Comparing Liposomal Bupivacaine versus Traditional Modalities on Post-operative Length of Stay LT Kyleigh Hupfl, PharmD 1 1 Naval.
An Audit of Hip Fracture Analgesia at Darent Valley Hospital Dr D Neely, Dr M Kanagarathnam, Dr M Satisha Department of Anaesthetics, Darent Valley Hospital,
Oncology Institute of Vojvodina Department of anaesthesiology and intensive care Institutski put 4, Sremska Kamenica, SERBIA
PAIN MANAGEMENT IN PEDIATRIC ORTHOPAEDIC SURGERY JUSTIN LUCAS – T4.
A COMPARISON OF THE DURATION OF BRACHIAL PLEXUS BLOCK BETWEEN ULTRASOUND GUIDED AND NERVE STIMULATOR TECHNIQUES IN ELECTIVE SHOULDER SURGERY A. Smith 1,
The Effects of Intravenous Acetaminophen Use on Robot-Assisted Pelvic Surgery Patients Nichole Witmyer, Pharm.D. St. Dominic Hospital Jackson, Mississippi.
Introduction Postoperative pain following cardiothoracic surgery can delay rehabilitation, increase morbidity and mortality, and may lead to persistent.
Patient Experience of Care Surveys
Acupuncture as an Effective Method for Pain Management in Post-Op Care
This is the biggest, trainee led, prospective national paediatric audit to date Our hospital is taking part.
بسم الله الرحمن الرحيم ( هُوَ الَّذِي أَنْزَلَ السَّكِينَةَ فِي قُلُوبِ الْمُؤْمِنِينَ لِيَزْدَادُوا إِيمَانًا مَعَ إِيمَانِهِمْ )   * الفتح/4.
From: Anesthetic Technique for Radical Prostatectomy Surgery Affects Cancer Recurrence:A Retrospective Analysis Anesthes. 2008;109(2): doi: /ALN.0b013e31817f5b73.
Stepwise approach to assessing cardiac patient risk for noncardiac surgery. (Reproduced, with permission, from Fleisher LA et al. ACC/AHA 2007 Guidelines.
Stepwise approach to assessing cardiac patient risk for noncardiac surgery. (Reproduced, with permission, from Fleisher LA et al. ACC/AHA 2007 Guidelines.
(c ) Length of Hospital stay:
Audit Opioid use in palliative patients on general hospital wards
Survey of Dental Outpatient Anaesthesia Practice (DOPA) in Scotland
INTRAOPERATIVE ESMOLOL ADMINISTRATION IN MANAGING POSTOPERATIVE PAIN
Discontinued group (n=33)
Sensitivity Analyses Intraoperative neuromuscular blocking agent administration and hospital readmission Sub-cohort Frequency of readmitted patients (percent.
Yoga in therapy for chronic non-specific low back pain (CLBP) – a short term intensive yoga program for in-patients (project) Aleš Kubát MD Department.
Acute Neuropathic Pain:
From: Quality of Recovery from Anesthesia in Neurosurgical Patients
Educational Sites UCSD Thornton Hospital
From: Pain in 1,000 Women Treated for Breast Cancer:A Prospective Study of Pain Sensitivity and Postoperative Pain Anesthes. 2013;119(6): doi: /ALN
Time to pain resolution Pain impact on quality of life
Improving Surgical Patient Safety
Assessment and Management of Acute Pain: A Focus on the Role of Opioids and Multimodal Treatment Approaches.
Lessons Learned In Opioid Treatment From the Pain Action Consulting Team.
Irish Hip Fracture Database
Acute pain service: organization, the view of the physician
A Gray, H Kehlet, F Bonnet, N Rawal  British Journal of Anaesthesia 
Madeleine robinson, dr alan mcshane, dr neil mcdonald
Background Cancers are among the leading causes of morbidity and mortality worldwide, responsible for 18.1 million new cases and 9.6 million deaths in.
Rehabilitation following surgery for lumbar spinal stenosis
Managing Pain in the 21st Century
Championing Evidence-Based Care in Patients With Acute Low Back Pain
Evaluation of the local and systemic analgesic effects of dexamethasone in the upper arm bone fracture and shoulder joint surgery Jelena Kucina.
PowerPoint 16:9 Screen Ratio Template *
PRN Program: Acute Pain
Hazard ratios for associations between incident hepatitis C virus infection and prescribed dosage of opioid agonist treatment, categorized according to.
Presentation transcript:

Acute Pain after Surgery: Lessons Learned from the Last Decade Stephan A Schug Anaesthesiology & Pain Medicine University of Western Australia Royal Perth Hospital

American Pain Society, American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists “The panel recommends that clinicians offer multimodal analgesia, or the use of a variety of analgesic medications and techniques combined with nonpharmacological interventions, for the treatment of postoperative pain in children and adults (strong recommendation, high-quality evidence).” Note: Exact components of effective multimodal care will vary depending on the patient, setting, and surgical procedure. Chou R, et al. J Pain. 2016;17:131-57. 2

Procedure Specific Postoperative Pain Management (PROSPECT) Procedure Specific Postoperative Pain Management (PROSPECT). Available from: http://www.postoppain.org. Accessed June 2017.

Conclusions Initiate multimodal analgesic techniques Minimise use of opioids Maximise use of non-opioid agents Use regional anaesthesia whenever possible Superior to opioids, especially in orthopaedic patients Use evidence-based, procedure-specific pain management guidelines where available http://fpm.anzca.edu.au/Resources/Publications http://www.jpain.org/article/S1526-5900(15)00995-5/pdf http://www.postoppain.org 4