疼痛管理Acute Pain Management.ppt

Acute Pain ManagementParisa Partownavid, MDAssistant Clinical ProfessorDavid Geffen School of Medicine at UCLADepartment of Anesthesia Definition of Pain An Unpleasant Sensory and Emotional Experience Associated with Actual or Potential Tissue Damage, or Described in Terms of Such Damage. Acute Pain Pain in Perioperative Setting Pain in Patients with Severe or Concurrent Medical Illnesses (Pancreatitis) Acute Pain Related to Cancer or Cancer Treatment Labor Pain Acute Perioperative Pain Pain that is Present in a Surgical Patient Because of Preexisting Disease, the Surgical Procedure, or a Combination of Both Importance of  Pain Management Adequate Pain Control Reduce the Risk of Adverse Outcomes Maintain the Patient’s Functional Ability, as well as Psychological Well-being Enhance the Quality of Life Shortened Hospital Stay and Reduced Cost Adverse Outcomes Associated with Management of  Acute Pain Respiratory Depression Circulatory Depression Sedation Nausea and Vomiting Pruritus Urinary Retention Impairment of Bowel Function Adverse Outcome of Undertreatment of Acute Pain Thromboembolic or Pulmonary Complications Needless Suffering Development of Chronic Pain The Incidence of Moderate to Severe Pain with Cardiac, Abdominal, and Orthopedic Inpatient Procedures has been Reported as High as 25%-50%, and Incidence of Moderate Pain after Ambulatory Procedures is 25% or Higher. Goal Pain Management Interventions Should be Offered Around the Clock Pain Management is to Provide Continuous Pain Relief Patient Should be Assessed for Adequacy of Pain Control Preoperative Evaluation of the Patient Type of Surgery Expected Severity of Postoperative Pain Underlying Medical Condition (Respiratory or Cardiac Disease) Preoperative Preparation  of the Patient Adjustment or Continuation of Medications (Sudden Cessation may Provoke a Withdrawal Syndrome) Treatment to Reduce Preexist