Regional and Local Block of Acute Pain

Modern concepts of acute and chronic pain management

Both, acute and chronic pain should be treated using appropriate pain management as they may cause several negative reactions and jeopardise the health or at least the quality of life of the patients. Nowadays there are many analgesics and treatment tools available to provide sufficient pain relief for almost all patients. Unfortunately there are still patients suffering from pain due to inadequate or/and inconsequent pain therapy.

Acute pain management: operative or medical procedures and trauma

OBJECTIVE

To review the topics presented in the Agency for Health Care Policy and Research (AHCPR) Clinical Practice Guideline for Acute Pain Management and provide updated information on therapeutic issues as necessary.

DATA SOURCES

AHCPR Clinical Practice Guideline for Acute Pain Management: Operative or Medical Procedures and Trauma. A MEDLINE search (1990 to June 1996) of English-language literature pertaining to pain assessment and management was performed. Reference lists from relevant articles also served as a literature source.

STUDY SELECTION AND DATA EXTRACTION

All articles identified from the data sources were evaluated. Relevant information, as determined by the authors, was included in the review.

DATA SYNTHESIS

Inadequate acute pain management continues to be recognized as a problem due to limited health professional education on the treatment of pain, inadequate patient empowerment, negative connotations associated with opioid analgesics (e.g., fear of "addiction"), federal regulations associated with prescribing opioid analgesics, and difficulty in assessing pain. The widespread inadequacy in pain management prompted the development of the AHCPR Clinical Practice Guideline for Acute Pain Management, which was published in 1992. In addition to reviewing the pain guideline, this article includes updated information on ketorolac tromethamine, tramadol, local anesthetics, sedation, regional anesthetic techniques, and the management of opioid adverse effects.

CONCLUSIONS

The AHCPR Clinical Practice Guideline for Acute Pain Management is a comprehensive, yet functional, review for clinicians. Most issues relating to acute pain assessment and management are adequately discussed. Overall, this guideline is a worthwhile general resource to clinicians. It is important, however, for clinicians managing acute pain issues to supplement this guideline with more detailed and current information.