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The reasons for this are not clear but are probably related to fears of over dosage. Altered central nervous system sensory processing is a basic mechanism underlying postoperative pain. One such basic mechanism is the alteration of peripheral and central nervous system function. The total amount of opioid used is less with PCA than with intramuscular delivery. The small delay that results from performance of the blocks is outweighed by the benefit to the patient.
PCA provides better patient satisfaction and improved respiratory function than conventional routes for 32 6 administration of opioids.
In this context. In very young children observational measures may be helpful. There may be great difficulty in communication and assessment and the choice of analgesic techniques should reflect this. Assessing simple factors such as whether or not the child is asleep. As a general rule the elderly report pain less frequently and require smaller doses of analgesic drugs to achieve adequate pain relief. As with all pain. Assessment presents a major challenge. In practical terms. When analgesic drugs are given they may not be absorbed as well or metabolized as efficiently.
Pain relief in the elderly1 The elderly also present special problems in the provision of analgesia. A major problem in treating pain in children is associated with the difficulty in assessment. But there is no evidence to support the idea that pain is less intense in neonates and young children due to their developing nervous system. Rawal and 14 Klein report a trend towards discharging patients with indwelling nerve block catheters.
This will result in improved postoperative analgesia. Children tend to receive less analgesia than adults and the drugs are often discontinued sooner.
The elderly are more likely to be receiving more than one drug for underlying medical conditions and the possibility of drug interaction is greater. These initiatives along with improved management of postoperative pain in hospitals may address the high rates of moderate to severe pain being reported by patients after Post-operative pain management Pain relief in children1 Management of pain in children is often inadequate and ignored previously with misconception of low intensity of pain.
Pulse Volume 5 1 Many patients are anxious. These efforts will provide health care professionals with comprehensive feedback so they may strive for both clinical excellence and professional fulfillment.
Conclusion Acute pain management services APMS evolved in response to the desire for improved management of postoperative pain. Assessment of pain may be carried out by normal methods and conventional numerical or graphical methods work well.
Christofer L. McArdle CS. Canadian Nurse World Federation of Societies of Anaesthesiologists. Miller 6 edition Ritchie E. Woolf CJ.
Peripheral mechanisms of somatic pain. Good M. Acute post-operative pain. The future looks bright with all these new techniques and drugs. Chong MS. Salter MW.
Acute postoperative pain. Raja SN. Klein SM. Postoperative pain in ambulatory surgery Can J Anesth. Douglas Justins. Systematic relaxation to relieve postoperative pain. Allvin R. Blackwell Publishing. Managing post-operative pain at home. As John Dryden Says. Beyond the hospital: David H.
Brown R. Chung F. Issue 7. Warltier DC.
Baker CJ. Acute pain management services have progressed. Pagel PS. Home plexus catheters after major limb surgery. MacDonald V. Meyer RA. Kersten JR.
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