Organization of the Acute Pain Units: State of Art in Portugal

Abstract

Introduction: According to the of the National Health Service National Guidance’s of 2012, the presence of an Acute Pain Service (APS) is mandatory in the Hospitals of the National Health System with a surgical service, however it is known that these are not fulfilled in its totality.

Methods: National survey directed to 39 hospital institutions.

Results: Of the 39 respondents, 27 answered. There is an APS in all institutions and everyone gave utmost importance to their existence. In 7.4% of the institutions, the APS is constituted by a multidisciplinary team and in 77.8% there is an APS in all surgical services. Most have one in charge and in 55.6% there is a scaled anaesthetist. Ninety six percent have working protocols, 77% have training programs and 22.2% say they do not have the necessary devices. There were several hospital institutions with multiple answers, differing from each other.

Discussion and Conclusion: Comparison of results with previous studies is limited. The APSs are given great importance and according to the norms, it is verified that there is an APS in all institutions, with a responsible and an anesthesiologist involved. However, the requirement for a multidisciplinary team, training and registers are not yet fully met, and there is still a high rate of lack of material. Two reasons cited for failure to comply with the guidance’s are the economic crisis and the lack of organization and communication within the institutions. One of the solutions could be to improve the communication and implementation of new strategies.