Factors That Increase Amylase Up The Recommended Infusion Rate

The morphine IV PCA and fentanyl ITS administer equally effective and equally safe medications that are used to treat acute postoperative pain (Lindley et al., 2009). These medications belong to the opioid agonist classification and provide relief from moderate to severe pain for clients hospitalized following surgical procedures. The patient can safely provide self-administration of a programmed dose to relieve pain by the push of a button (“IONSYS,” 2006; Lindley et al., 2009). Although highly effective at relieving pain, both medications must be monitored closely to safely prevent the common adverse

According to surveys, up to 80% of patients reported moderate to severe post-surgical pain, which can sometimes be left undertreated (Sinatra et al., 2005). Postoperative pain is generally managed with opioids, which carry numerous side effects. Side effects can be bothersome and possibly cause a delay in the postoperative healing process (Beard, Leslie, & Nemeth, 2011). IV acetaminophen can possibly decrease opioid consumption, minimize side effects, increase patient satisfaction, and decrease costs (Wininger et al., 2010). The purpose of this paper is to dive further into the research to present data on the effectiveness of IV acetaminophen in decreasing opioid usage and whether it produces an additive effect causing more effective pain management in the postop patient.

A physician with a wealth of experience in the fields of anesthesiology and pain management, Dr. Daniel Kendall has served as an interventional pain medicine specialist with National Spine and Pain Centers for 17 years. He treats patients out of National Spine and Pain’s Arlington location near his home town of Vienna, Virginia. Before assuming his current position, Dr. Daniel Kendall served as chief fellow of pain management at Johns Hopkins Hospital in Baltimore, Maryland. His experience with Johns Hopkins included training in advanced modalities such as sympathetic blocks, vertebroplasty, intrathecal pumps, IDET, radiofrequency ablation, and spinal cord stimulation.

Group N showing a faster onset compared to group B and the time that was taken to achieve complete block was shorter in group N. also, group N had prolonged postoperative analgesia (11).

Anne is currently taking paracetamol for the pain in her wrist, within healthcare analgesia should always be monitored to assess whether it is achieving elimination of pain and should be adapted to the individual patient (Vargas-Schaffer, 2010). If paracetamol were not effective in eliminating Anne’s pain then practitioners should consider a non-steroidal anti-inflammatory medication [NSAIDS] or a mild opioid medication such as codeine as the next step (Vargas-Schaffer, 2010). However as Anne is asthmatic NSAID medication should be used with caution due to the risk of increased frequency of asthma attacks and breathlessness (Joint Formulary Committee, 2015); if Anne has taken NSAIDS before with no issue then this would be the next choice of analgesia followed by codeine if combined paracetamol and NSAID did not prove effective (Vargas-Schaffer,

The practice of patient-controlled analgesia (PCA) has been around for approximately four decades now. During this time there have been improvements to the technology and the understanding of how to use this form of patient pain control; however, there continues to be concern related to the safety and efficacy of PCA. As this analysis proceeds it will briefly explain what PCA is and how it is used, then delve into the benefits and the safety issues surrounding PCA use as it pertains to the patient and the nurse. Some of the benefits of PCA include improved pain management, improved use of nursing resources, increased patient satisfaction, and reduced pulmonary issues (Hicks, Sikirica, Nelson, Schein & Cousins, 2008). Some of the safety

Narcotic analgesics, especially morphine are underused for pain control with in the medical field. This underuse is because medical professionals, including doctors, fear patient addiction, side effects and possible lose of their licenses. These fears deny adequate healing and a better quality of life to those who would benefit from a more effective use of these drugs, as done in hospice care.

According to Hah et al. (2017), several studies have shown that nerve blockade of the central nervous system (neuraxial anesthesia) or peripheral nerves (regional anesthesia) reduce the need for opioids in the immediate postoperative phase. There are two mechanisms through which nerve blockade reduces persistent opioid use. First, nerve blockade works by impeding the transmission of pain during the perioperative phase and thereby stopping central sensitization and chronic neuropathic pain. Second, nerve blocks are effective in treating postoperative pain and are good predictor of persistent opioid use. Similarly, studies found that intravenous local anesthetic such as lidocaine reduces perioperative opioid

postoperative pain. (6) However, the effects of these drugs on pain control are compared in

The selected policy Essence of Care 2010: Benchmarks for the Prevention and Management of Pain, includes the latest benchmarks on the management of pain and its prevention. It presents up to date reviewed views, with the aim to deliver

Multimodal or balanced analgesic techniques involving the use of smaller doses of opioids in combination with non-opioid analgesic drugs (eg, local anesthetics, ketamine, acetaminophen, and NSAIDs) are becoming increasingly popular approaches to preventing pain after surgery [36]. There is evidence showing the benefits of multimodal analgesic techniques, but major surveys have reported that these techniques are underused in clinical practice [37]. Multimodal analgesia is achieved by combining different analgesics that act by different mechanisms at different sites in the nervous system, reducing the incidence of side effects owing to the lower doses of the individual drugs. In our study from all the prescribed analgesics only 23 (19.2%) charts were done according to the multimodal pain management for postoperative pain where as the remaining 97 (80.8%) prescriptions were not in accordance with MAPP (Table

decreases pain is unknown. However, theory supported in animal studies shows the analgesic effects of sucrose can be reversed by using naltrexone. Further studies show that infants who were born to mothers being treated with methadone did not demonstrate the same analgesic effects from sucrose. These findings are essential in demonstrating that the decrease in pain is not similar to the response elicited by non-nutritive (NNS) sucking and decrease pain through activation of a different neurological pathway. The main point is the effect of sucrose on pain relief is linked to the sweetness of the solution, as seen with other sweetening solutions such as glucose (McCall, DeCristofaro, & Elliott, 2013).

In order to determine if Patient Y was having pain, I assessed her pain level using a pain scale. Once she reported a pain score of a 10 out of 10, I reviewed the pain medications that were ordered for her and chose the medication indicated for severe pain. After 30 minutes I reassessed my patient pain score and the rating changed to a 5 out of 10. During this time, I educated Patient Y on other techniques to decrease her pain. I provided Patient Y with an abdominal binder to place over her abdomen and constrict to the incision. I also told Patient Y to hold a folded blanket on her incision if she needs to cough or sneeze to decrease the pain. Finally, I educated Patient Y on breathing techniques to also decrease her pain.

With proper pain control patients are able to ambulate earlier, reduces risks of cardiac issues, reduces the risk of thrombosis, quicker recovery, decreased risk of neuropathy, and reduces the cost of care (Ramsay, 2000). This article shows studies that have proven that a major side effect of improper pain control is hospital acquired delirium.

The management of postoperative pain has received much interest nowadays. The intensity of postoperative pain depends on many factors such as type and duration of the surgery, type of anesthesia and analgesia used, and the patient’s mental and emotional status (11).