Managing acute postoperative pain: is 3 hours too long?

Autor: Ang P; Postanesthesia Care Unit, Miami VA Health Care System, FL 33125, USA. philipkang2000@yahoo.com, Knight H, Matadial C, Pagan A, Curty R, Nieves CS, Acevedo AA, Dalisay FP
Jazyk: angličtina
Zdroj: Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses [J Perianesth Nurs] 2004 Oct; Vol. 19 (5), pp. 312-30; quiz 331-3.
Abstrakt: This case study discusses a 64-year-old opioid-tolerant patient who underwent amputation below the left knee and received pain management in the PACU. The patient's self-reported pain level remained 9 on a 0 to 10 scale despite having received a total of 62 mg of morphine sulfate (MSO 4 ) and 60 mg of ketorolac in just less than 3 hours. The patient's facial expression corresponded to a score of 4 to 5 based on the Wong-Baker Faces Pain Scale. This case study illustrates that it is crucial to promptly involve the pain management service when an opioid-tolerant patient requires aggressive pain treatment. The initial patient-controlled analgesia (PCA) order and MSO 4 -loading doses must take into account the patient history of opioid tolerance, increasing the frequency and dosage-loading doses of MSO 4 for treating severe pain until the patient's pain is reduced by at least 50% on a numeric scale, or until the patient states satisfactory relief. The most important rule of pain management is that pain is what the patient says it is.
Databáze: MEDLINE