Optimal Postoperative Pain Control: A Case Study

When managing the childs pain during cancer treatment the nurse must work with an interdisciplinary team involving many different experts to come up with the best possible pain management plan for the child. The nurse would be the one to carry this plan out in the child’s care. Knowing what opioid’s, nonopioids, NSAIDS, acetaminophen with codeine, oxycodone, and morphine to give during different times is crucial. The nurse must also know the side effects of these medication and monitor the child closely.

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

In order to discover the effectiveness of IV acetaminophen on opioid use for postoperative pain, a detailed question must be asked to provide guidance for a search. The question asked has five pieces: (P) population, (I) intervention, (C) comparison, (O) outcome, and (T) timing (Melnyk & Fineout-Overholt 2011). The full PICOT question is as follows: For surgical patients receiving general anesthesia, does the use of post-operative IV acetaminophen influence post-operative opioid usage to control pain during the inpatient

Last semester in clinical, there was a patient with sickle cell anemia and he automatically sparked an interest in me. The patient was quite young and was in so much pain that he could not even bear to be touched by the nurse and reported a pain level of 8. Before my encounter with this patient, I did not know much about sickle cell anemia and decided to do some research on this disease. In my research, I learned that a majority of these patients go through acute pain episodes that occur chronically. After learning this and thinking about the young boy in the hospital, I wanted to discover more about how the pain in these patients are managed and controlled.

Despite recent advances in information regarding perioperative care, postoperative pain continues to go undermanaged. Postoperative pain is the pain patients experience after a surgical procedure. According to Gan, 80% of all people who undergo surgeries experience postoperative pain, and 75% of them rate their pain at a moderate, severe, or extreme level (as cited by Cooney, 2016). Furthermore, inadequately managed pain can lead to patient dissatisfaction, decreased patient outcomes, and overall higher cost of care (Penprase, Brunetto, Dahmani, Forthoffer & Kapoor, 2015). In order to provide higher quality pain management,

The first 48 hours of pain analysis and treating the pain of the patient to the hospice (or end-of-life patient in any other stetting) are crucial. However, the patient may be unable to speak and articulate his pain, or may be able to inadequately express the symptoms. One of the major concerns for those who are at the end of life is

Acute pain following a surgical procedure is one of the most common stimuli experiences by pediatric patients. Pediatric postoperative pain management has long been overlooked and treated differently than adult pain management. There tend to many misconceptions when it comes to pediatric pain management stemming from the belief that children do not experience pain the same way as adults. Since the pediatric population is not legally allowed to make medical decisions, guardians must make these decisions for them.

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).

This feature also enables the use of this technique into the postoperative period for analgesia, using lower concentrations of local anaesthetic drugs or in combination with different agents.

Septoplasty, for symptomatic deviated nasal septum, is a commonly practiced surgery in ENT. After septal operations, nasal packing helps to minimize the dead space and bleeding from surgery site. In addition to prevent nasal bleeding, these materials also support the septal mucoperichondrial flaps and minimize the risk of formation of septal hematomas and adhesions.2

The goal of a facet medial branch block injection is to block the medial branch nerve endings located within the facet joint as seen in figure 3. These injections can be both diagnostic and therapeutic. According to Iannuccilli et al. (2013), two diagnostic facet medial branch block injections are typically performed using a local anesthetic agent and a therapeutic injection is done with a corticosteroid if both diagnostic tests yielded positive results. Routinely, there are six injections for one procedure that would cover L4/L5 and L5/S1 bilaterally. The needle target is usually the L3 and L4 medial branches and the dorsal ramus of L5 bilaterally. Just like an epidural, the procedure begins with a true AP image with the patient lying prone. The injection for L5/S1 is typically done in a true AP. However, for the L4/L5 facet joint, the c-arm is rotated 30 degrees to expose the pedicle located below the junction of the superior articular process and transverse process. The facet medial branch block injection provided both short-term and long-term relief according to the studies collected on the systematic review by Manchikanti et al

Pain is the way the body communicates and lets us know that there is something wrong that needs attention. The brain processes that sensation into information and that leads us to take action. If it is a natural part of our beings and is necessary then why do we do all we can to suppress it? There is a fine line between pain that is needed to help with function and pain that is there that disturbs homeostasis. There is also a question of is pain real or is it all in the mind. Pain and being able to manage it, is a very big component in the perioperative setting. It is triggered differently and is unique to each person this make treating pain just as unique. This paper will discuss pain management in the pre-operative, intra-operative and post- operative settings.

DOI: 12/19/2015. Patient is a 23-year-old male field technician who sustained injury while removing a ladder from a truck. Per OMNI, he was initially diagnosed with back sprain/strain.

In adequate post-operative pain management and assessment postpones patient discharge and delays recovery affecting 24% of patients. As a result there are increased readmissions and prolonged length of stays in hospital, and also poor clinical outcomes for the patient.

Pediatric pain management is measured subjectively because it is based off of what the patient says or how the nurse interprets the pain scale. Pain is rated using different scales, unfortunately these different scales could yield different results. Nurses are trained to use pediatric pain scales to analyze and treat pain but parents are not supplied with the tools to manage pain when the patient goes home. With 84% of all pediatric surgical procedures performed on an outpatient basis, the importance of teaching parents how to assess for and manage pain has become more important than ever (Rony, Fortier, Chorney, Perret, & Kain, 2010). According to Rony’s et al. (2010) study, it is apparent that pediatric pain is not being treated effectively. The study showed that 58.8% of children were receiving less than the daily recommended does prescribed by the pediatrician (p.1). Results of the study also showed that parents had false assessments on if their child was actually in pain. 36% of parents believed that if their child was in pain, they would cry out for the parent , 30% agreed that their child would always tell them if they are in pain, while 22% said that the child would report their pain immediately (Rony, Fortier, Chorney, Perret, & Kain, 2010, ). Children do not always verbalize when they are in pain. Sometimes the pain can be so intense that a child is unable to talk. If the child catches on to the parents negative perception of pain medications, the child may not