Pain therapy - Post Operative Pain Management

Pain Therapy
Types Of Pain
Why We Assess Pain?
Visual Analog Scale (VAS )
Verbal Numerical Rating Scale
(VNRS )
Surgical Pain
Methods To Treat Post Operative Pain

1. Pain Therapy
Mr. Harshad Khade
MSc. Medical Technology (OTA)
Symbiosis International university, Pune.

2. Pain
•Pain is an unpleasant sensory and emotional
experience associated with actual and potential
tissue damage.
•According to Katz and Melzack,
•Pain is a personal and subjective experience that can
only be felt by the sufferer.

3. Types Of Pain
•Acute pain
•Cutaneous pain
•Deep somatic pain
•Visceral pain
•Chronic pain
•Referred pain
•Neuropathic pain
•Phantom pain

4. Goals Of Post Operative Pain
Management
•To Reduce Pain
•To Improve Quality Of Life
•To Reduce Morbidity
•To Facilitate Rapid Recovery
•To Early Hospital Discharged

5. Benefits Of Effective
Post Operative Pain Management
•To Decreased Complications
•It May decreased chronic pain
syndrome
•It may decreased hospital stay
•To Decreased costs
•To Increased patient
satisfaction
•To Increased resource
utilisation

6. Why We Assess Pain?
•To establish degree and nature of pain
•To ensure patient comfort
•To evaluate effectiveness of analgesia
•To help alleviate anxiety
•To decide on type of analgesia
•To aid recovery and prevent complications

7. Pain Assessment Scale
•Visual analogscale (VAS )
•Verbal numerical rating scale (VNRS )
•Categorical rating scale

8. Visual Analog Scale (VAS )

9. Verbal Numerical Rating Scale
(VNRS )

10. Categorical Rating Scale
Categorical Rating Scale
None 0
Mild 2-3
Moderate 4-5
Severe 6-7
Very Severe 8-9
Worst Pain 10

11. Why Treat Pain?
•Basic human right !
•Moral responsibility
•Decreased suffering and post operative
complications
•Decreased likelihood of chronic pain development
•Increased patient satisfaction

12. Causes Of Variation In
Analgesic Requirements
•Site and types of surgery
•Age, gender
•psycologicalfactors
•Pharmacokinetic variability
•Pharmacodynamics variability

13. Surgical Pain
Mild Intensity Pain Moderate Intensity Pain Severe Intensity Pain
•Herniotomy
•Varicose vein
•Gynecological
laparotomy
•Hip replacement
•Hysterectomy
•maxillofacial
•Thoracotomy
•Major abdominal
surgery
•Knee surgery
•Paracetamol / NSAID’s
•Weak opioid’s
•Wound infiltration
•Regional block
analgesia
•Paracetamol / NSAID’s
+ wound infiltration
•Peripheral nerve block
•Systemic opioid's
•PCA
•Paracetamol / NSIAD’s
+ wound infiltration
•Epidural anesthesia
systemic opioids
•PCA

14. Methods To Treat Post Operative Pain
•Pharmacologic: ( medications )
•Acetaminophen( Paracetamol )
•NSAID’s
•Opioid’s
•Alpha-2 agonists
•Procedures
•Regional Anaesthesia
•LA Infiltration at incision site
•Non-Pharmacologic Approaches
•Music and Audioanalgesia
•Transcutaneous electrical
nerve stimulation (TENS)

15. Important Safety Information
Safety information
•Recommended doses and time intervals
•Adjust doses to actual pain, e.g.reduce over time as pain
intensity decreases.
•Possible interactions
•Describe symptoms of overdose / toxicity
•Local anaesthetic analgesia : care of insensate limbs
•Telephone number to responsible clinic day & night

16. Summary
•Analgesia should be timely and effective
•Balanced approach is recommended
•Regional LA analgesia has many benefits –but must
be met and replaced by other analgesics before it
is withdrawn.

17. “
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Thank You
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