Biological Cascade: Efficacy of Multimodal Analgesic Administration
Added on 2020-01-07
13 Pages4105 Words190 Views
Healthcare and Research
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Patient controlled surgical pain management 1Patient controlled surgical pain managementStudent's Name:Instructor's Name:Date:
Patient controlled surgical pain management 2Patient controlled surgical pain managementIntroduction:In a majority of patients undergoing surgical procedures, the incidence of postoperativediscomfort and acute presence of pain is a consistent occurrence [1]. The pain reported by mostpatients range from being moderate, severe or even extreme in some cases [1]. Due to theincidence of such persistent and acute pain in patients is of considerable severity [1]. Theevidence present in literature and as suggested by research, the relief of postoperative pain inmost patients is reported as being low and the postoperative pain relief is mostly inadequate [1].The control of postoperative pain is inadequate in most cases and thus most aspects of thepatient’s life are impacted [1]. The quality of life, mobility, and activities of daily life areaffected adversely due to the persistent pain [1]. Postsurgical pain, thus affects the functioning ofthe patient in everyday life and the recovery of functionality, postsurgical complications, andinadequate response to pain stimuli [1]. The common interventions undertaken at the various stages of surgery are mostly ineffective inpain management [1]. The common interventions are carried out firstly in the preoperative stagewherein there is no specific requirement for pain relief or management [1]. The next stage ofmedical intervention is the intraoperative stage [1]. Intraoperative pain management mainlyincludes immediate symptom relief and management of discomfort affecting the surgicalprotocol [1]. Further, the final stage includes the postoperative intervention that involves themanagement of pain in individuals following the surgery [1]. Research indicates that mostpostsurgical interventions do not adequately address the pain and the relief from pain is notachieved in absolution [1]. The persistence of postsurgical pain is a limiting factor in the lives of
Patient controlled surgical pain management 3the patients and thus, the degree of their functionality is greatly reduced [1]. The discomfort andpain present in individuals at the postsurgical stage mainly leads to reduced quality of life anddecreased mobility [1]. The medical interventions and strategies of management of pain althoughavailable in most patient care facilities, the research and evolution of more efficient painreduction strategies is a continuous process [1]. The American Pain Society (APS) with theinclusion of research conducted by the American Society of Anesthesiologists (ASA) hascommissioned a guideline document for the effective management of pain in postoperativepatients [1]. The guideline emphasizes the management of postoperative pain in the patients byway of promotion of techniques which rely on the evidence of incidence of pain [1]. The painmanagement technique needs to be chosen primarily on the basis of the effectiveness and safetyof the technique [1]. Since the pain management needs to be carried out in both children andadults, the effectiveness of the pain management technique depends on the medical interventionand effective identification of pain [1]. The areas of pain management that need to be addressedinclude raising awareness and educating the patients at the preoperative stage, the effectiveplanning of pain management at the perioperative intervention stage, use of variant strategies ofmodalities belonging to pharmacological and non-pharmacological categories, policies andprocedures that are mainly of the organizational importance [1]. The final stage is the transitionof the intervention into the stage of caring for outpatients [1]. The pain relief in postoperativepatients is linked to mobilization and functionality in daily life [1]. Due to this, most patientsneed to undergo several physiotherapy and medical interventions without achieving complete oreven satisfactory pain relief [1]. The use of analgesics in pain management is a topic of muchdebate research concerning postoperative pain relief [1]. The comfort level of the patient ismostly connected to satisfactory relief from pain and ease of mobility [1].
Patient controlled surgical pain management 4Poor recovery of functional aspects in postsurgical patients has been associated with inadequatemanagement of postsurgical pain [1]. This leads to the activation of a variety of cascade systemsof biological functions in the body following the surgical procedure [1]. This results in sideeffects such as ileus, delayed or compromised mobility, limitations in feeding, nausea, delay indischarge from hospital, and readmission into hospital care at unexpected instances [1].Therefore, understandably, the primary concern in most patients is the incidence of pain in thepostsurgical phase [1]. The upper extremities tend to be relatively more vulnerable to theincidence of injury due to which they have a higher predisposition to surgical interventions [1].Additionally, since the upper extremities typically have the utility for multiple joints, they havethe requirement for fine degrees of manipulation of the joints [1]. Thus, when there is a poorintervention setup of postoperative rehabilitation and pain management along with longerperiods of immobilization ultimately result in several complications [1]. Common complicationsinclude stiffness of the joint and complex regional syndrome [1]. These complications haveseveral negative implications on the functional outcomes in most postoperative patients [1]. Asan important part of the pain management technique in postoperative patients, analgesia has beenused as a primary agent in most interventions [1]. Patient controlled epidural analgesia (PCEA):Pain control is considered as one of the most important considerations in postsurgicalinterventions [2, 3]. The primary reason for this is that pain control has been linked tomobilization at the earlier stages, improvement in the total range of motion, and overall reductionin the time taken for complete healing [2, 3]. The cost of medical intervention and the length ofstay that are affected by the surgical process cause a significant limitation in the quality of life of
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