Pain Assessment Dr Leon Malzinskas SMO BCRH Wonthaggi Hospital
Pain Definition Sensory and emotional experience associated with actual or potential tissue damage
Post operative pain Acute Nociceptors and Neuropathic pain Surgical pain
Why is control important Delays post op recovery Increases morbidity Delays return to normal function Restricts mobility -> thromboembolism Catecholamine release Pulmonary dysfunction
Assessment Pre op prediction Post op subjective assessment Post op objective assessment
Pre op assessment Past medical and surgical history Current Rx (prescribed and illicit) Allergies Past pain history and treatments Patients expectations of pain Advice re pain Mx and modes of delivery How we measure pain and patients reporting
Subjective assessment Pain scales - single dimensional and multi dimensional
Objective Look at the patient Physiological parameters Functional parameters
Outcomes assessment Response to therapy
Practicalities Pre op assessment Prediction of pain Preempt with preventative Rx Assess post op subjectively and objectively Treat with appropriate Rx Assess response Modify Mx
Summary Preop assessment Knowledge of surgery Simple and quick assessment tools Outcome assessment regularly