Portuguese Society of Anesthesiology Recommendations for the Treatment of Acute Pain 2018
DOI:
https://doi.org/10.25751/rspa.15020Keywords:
Acute Pain/drug therapy; Analgesia; Analgesia, Patient-Controlled; Consensus; Pain, Postoperative/drug therapy; PortugalAbstract
Acute pain has been undertreated for decades. The solution does not seem to depend on the development of new drugs or analgesic techniques but rather in the standardization of all procedures. The role of acute pain services to improve pain management and outcome is well accepted but its implementation seems challenging. The Ministry of Health has officially published a document that made mandatory the existence of an acute pain service in all hospitals, regulating every aspects of its organization and defining the criteria for evaluating its implementation. The Portuguese Society of Anaesthesiology has set up a working group to approach these questions and produce practical clinical consensus.
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References
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6. Meissner W, Coluzzi F, Fletcher D, Huygen F, Morlion B, Neugebauer E, et al. Improving the management of postoperative acute pain: priorities for change. Curr Med Res Opin. 2015;31:2131-43. doi: 10.1185/03007995.2015.1092122.
7. Rawal N. Current issues in postoperative pain management. Eur J Anaesthesiol. 2016;33:160-71. doi: 10.1097/EJA.0000000000000366.
8. Zeppetella G. The WHO analgesic ladder: 25 years on. Br J Nurs. 2011;17:S4-6.
9. Bonet F. Postoperative pain management and outcomes after surgery. Best Pract Res Clin Anaesthesiol. 2007;1: 99-107
10. Direção Geral de Saúde. Plano de Luta contra a Dor. Lisboa: DGS; 2011. [consultado em Agosto 2018] Disponivel em: https://www.dgs.pt/documentose-publicacoes/plano-estrategico-nacional-de-prevencao-e-controlo-da-dorpenpcdor-pdf.aspx
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13. Joshi GP, Schug SA, Kehlet H. Procedure-specific pain management and outcome strategies. Best Pract Res Clin Anaesthesiol. 2014; 28: 191-201. doi: 10.1016/j.bpa.2014.03.005.
14. PROSPECT: evidence based, procedure-specific postoperative pain management. Best Pract Res Clin Anaesthesiol. 2007; 21: 149-159
15. Lynne Campbell, John Plummer: Guidelines for the Implementation of Patient-Controlled Analgesia. In: Disease Management and Health Outcomes. Berlin: Springer; 1998. p. 27-39.
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19. Schug SA, Manopas A. Role of non-opioids for postoperative pain treatment. Best Pract Res Clin Anaesthesiol. 2007;1:15-30
20. Pergolizzi J, Böger RH, Budd K, Dahan A, Erdine S, Hans G, et al. Opioids and the Management of Chronic Severe Pain in the Eldery: Consensus Statement of an International Expert Panel with Focus on the Six Clinically Most Often Used World Health Organization step III Opioids (Buprenorphine, Fentanyl, Hydromorphone,
Methadone, Morphine, Oxycodone). Pain Pract. 2008;4:287-313.
21. Buvanendran A, Kroin JS. Useful adjuvants for postoperative pain management. Best Pract Res Clin Anaesthesiol. 2007;1: 31- 49.
22. De Kock MF, Lavand’homme PM. Clinical role of NMDA receptor antagonists. Best Pract Res Clin Anaesthesiol.2007;1: 85-98.
23. Vila H Jr, Smith RA, Augustyniak MJ, Nagi PA, Soto RG, Ross TW, et al. The efficacy and safety of pain management before and after implementation of hospitalwide pain management standards: is patient safety compromised by treatment based solely on numerical pain ratings? Anesth Analg. 2005;101:474–80.
24. Eriksson K,Wilkstrom L, Arestedt K, Fridlund B, Brostrom A, Numeric Rating Scale: patient`s perceptions of its use in postoperative pain assessments. Appl Nurs Res. 2014; 27: 41-6.
25. Breivik H, Borchgrevink PC, Allen SM, Rosseland LA, Romundstad L, Hals EK, et al. Assessment of pain. Br J Anaesth. 2008;101:17-24. doi: 10.1093/bja/aen103.
26. Practice Guidelines for the Prevention, Detection, and Management of Respiratory Depression Associated with Neuraxial Opioid Administration. Anesthesiology. 2016;124;535-52. doi: 10.1097/ALN.0000000000000975.
27. Taufen A. 13 ways you can improve patient safety. Medical Group Management Association. March 2012. [consultado em Agosto 2018] Disponivel em: http://www.inpracticemanagement.com/ckfinder/userfiles/files/March%202012%20Newsletter.pdf
28. Love BL, Jensen LA, Schopflocher D, Tsui BCh. Development of an electronic database for Acute Pain Service outcomes. Pain Res Manag. 2012;1:25-30.
29. Direção Geral da Saúde. Circular Normativa Nº 09/DGCG de 14/06/2003. A Dor como 5º sinal vital - Registo sistemático da intensidade da Dor. Lisboa: DGS; 2003.
30. Ministério da Saúde. Diário da República, 2.ª série, n.º 36. Despacho nº2784. 20 de Fevereiro de 2013.
31. Goldstein DH, Phelan R, Wilson R, Ross-White A, VanDenKerkhof EG, Penning JP, et al. Brief review: adoption of electronic medical records to enhance acute pain management. Can J Anesth. 2014;61:164-79.
32. Medical Protection Society. An essential guide to medical records-advice for the United Kingdom. [consultado Dez 2017]. Disponível em: https://www.medicalprotection.org/uk/articles/an-mps-essential-guide-to-medical-records
33. Procuradoria Geral Distrital de Lisboa. Lei nº 12/2005 de 26 de Janeiro - Informação genética pessoal e informação de saúde.
34. Comissão Nacional de Proteção de Dados. Regulamento Geral de Proteção de Dados Lisboa: RGPD; 2018.
35. National Institute for clinical excellence, NHS CHI. Royal College of Nursing. University of Leicester. Principles for best practice in clinical audit [consultado em Agosto 2018] Disponível em: http://www.nice.org.uk/media/796/23/BestPracticeClinicalAudit.pdf
36. Kötter T, Blozik E, Scherer M. Methods for the guideline-based development of quality indicators – a systematic review. Implement Sci. 2012 ; 7:21. doi: 10.1186/1748-5908-7-21.
37. Wollersheim H, Hermens R, Hulscher M, Braspenning J, Ouwens M, Schouten J, et al. Clinical indicators: development and applications. Neth J Med. 2007;65:15-22.
38. Royal College of Anaesthetists. Raising the Standard: a compendium of audit recipes. In: Vickers A, Grady K, editors. Section 11: Pain Medicine. 3rd ed. London: Royal College of Anaesthetists; 2012. p 291-341.
39. Mainz J. Defining and classifying clinical indicators for quality improvement. Int J Qual Health Care. 2003;15:523-30.
40. Societal Impact of Pain: Quality indicators of chronic pain management Rolf-Detlef Treede. [consultado Julho 2018] Disponível em: https://www.sip-platform.eu/resources?page=67
41. SINAS – Sistema Nacional de Avaliação em Saúde – Melhores cuidados, melhores resultados. Manual de especificações – Avaliação da Dor Aguda. Lisboa: SINAS;2017.
42. Australasian Clinical Indicator Report 2009-2016.18th ed.. Anaesthesia and perioperative care version. Melbourne: ACIR; 2017.
43. The American Society of Anesthesiologists. Practice Guidelines for Acute Pain Management in the perioperative setting. Anesthesiology. 2012; 116: 248-73. doi: 10.1097/ALN.0b013e31823c1030.
44. Joint Commission on Accreditation of Healthcare Organizations, JCAHO. Improving the Quality of Pain Management Through Measurement and Action. [consultado em Agosto 2018] Disponível em: https://www.npcnow.org/system/files/research/download/Improving-the-Quality-of-Pain-Management-
Through-Measurement-and-Action.pdf
2. Schug SA, Palmer GM, Scott DA, Halliwell R, Trinca J. SE Working Group of the Australian and New Zealand College of Anaesthetists and Faculty of Pain Medicine 4th ed. In: Acute Pain Management: Scientific Evidence. Melbourne: ANZCA & FPM; 2015.
3. Direção Geral da Saúde. Norma 003/2012. Organização das Unidades Funcionais de Dor Aguda. Lisboa: DGS; 2012. [consultado em Agosto 2018] Disponível em: http://www.dgs.pt/directrizes-da-dgs/normas-e-circularesnormativas/norman-0032012-de-19102012.aspx.
4. Chou R, Gordon DB, de Leon-Casasola OA, Rosenberg JM, Bickler S, Brennan T, et al. Guidelines on the Management of Postoperative Pain Management of Postoperative Pain: A Clinical Practice Guideline From the American Pain Society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists’ Committee on Regional Anesthesia, Executive Committee, and Administrative Council. J Pain. 2016;17:131-57. doi: 10.1016/j.jpain.2015.12.008.
5. Sinatra R. Causes and consequences of inadequate management of acute pain. Pain Med. 2010;11:1859-71. doi: 10.1111/j.1526-4637.2010.00983.x.
6. Meissner W, Coluzzi F, Fletcher D, Huygen F, Morlion B, Neugebauer E, et al. Improving the management of postoperative acute pain: priorities for change. Curr Med Res Opin. 2015;31:2131-43. doi: 10.1185/03007995.2015.1092122.
7. Rawal N. Current issues in postoperative pain management. Eur J Anaesthesiol. 2016;33:160-71. doi: 10.1097/EJA.0000000000000366.
8. Zeppetella G. The WHO analgesic ladder: 25 years on. Br J Nurs. 2011;17:S4-6.
9. Bonet F. Postoperative pain management and outcomes after surgery. Best Pract Res Clin Anaesthesiol. 2007;1: 99-107
10. Direção Geral de Saúde. Plano de Luta contra a Dor. Lisboa: DGS; 2011. [consultado em Agosto 2018] Disponivel em: https://www.dgs.pt/documentose-publicacoes/plano-estrategico-nacional-de-prevencao-e-controlo-da-dorpenpcdor-pdf.aspx
11. Schug SA, Macintyre P, Power I, Scott D, Visser E, Walker S. The scientific evidence in acute pain management. Acute Pain. 2005; 7: 161-5.
12. Zaslansky R, Rothaug J, Chapman CR, Bäckström R, Brill S, Fletcher D, et al. PAIN OUT: the making of an international acute pain registry. Eur J Pain. 2015;19:490–502. doi: 10.1002/ejp.571.
13. Joshi GP, Schug SA, Kehlet H. Procedure-specific pain management and outcome strategies. Best Pract Res Clin Anaesthesiol. 2014; 28: 191-201. doi: 10.1016/j.bpa.2014.03.005.
14. PROSPECT: evidence based, procedure-specific postoperative pain management. Best Pract Res Clin Anaesthesiol. 2007; 21: 149-159
15. Lynne Campbell, John Plummer: Guidelines for the Implementation of Patient-Controlled Analgesia. In: Disease Management and Health Outcomes. Berlin: Springer; 1998. p. 27-39.
16. Schug SA, Palmer GM, Scott DA, Halliwell R, Trinca J. Acute pain management: scientific evidence. 4th ed. Bethesda: MJA; 2016.
17. Practice Advisory for the Prevention, Diagnosis, and Management of Infectious Complications Associated with Neuroaxial Techniques. Anesthesiology. 2017;4: 558-601. doi: 10.1097/ALN.0000000000001521.
18. Aubrun F, Marmion F. Postoperative pain in the elderly. Best Pract Res Clin Anaesthesiol. 2007;1:109-27.
19. Schug SA, Manopas A. Role of non-opioids for postoperative pain treatment. Best Pract Res Clin Anaesthesiol. 2007;1:15-30
20. Pergolizzi J, Böger RH, Budd K, Dahan A, Erdine S, Hans G, et al. Opioids and the Management of Chronic Severe Pain in the Eldery: Consensus Statement of an International Expert Panel with Focus on the Six Clinically Most Often Used World Health Organization step III Opioids (Buprenorphine, Fentanyl, Hydromorphone,
Methadone, Morphine, Oxycodone). Pain Pract. 2008;4:287-313.
21. Buvanendran A, Kroin JS. Useful adjuvants for postoperative pain management. Best Pract Res Clin Anaesthesiol. 2007;1: 31- 49.
22. De Kock MF, Lavand’homme PM. Clinical role of NMDA receptor antagonists. Best Pract Res Clin Anaesthesiol.2007;1: 85-98.
23. Vila H Jr, Smith RA, Augustyniak MJ, Nagi PA, Soto RG, Ross TW, et al. The efficacy and safety of pain management before and after implementation of hospitalwide pain management standards: is patient safety compromised by treatment based solely on numerical pain ratings? Anesth Analg. 2005;101:474–80.
24. Eriksson K,Wilkstrom L, Arestedt K, Fridlund B, Brostrom A, Numeric Rating Scale: patient`s perceptions of its use in postoperative pain assessments. Appl Nurs Res. 2014; 27: 41-6.
25. Breivik H, Borchgrevink PC, Allen SM, Rosseland LA, Romundstad L, Hals EK, et al. Assessment of pain. Br J Anaesth. 2008;101:17-24. doi: 10.1093/bja/aen103.
26. Practice Guidelines for the Prevention, Detection, and Management of Respiratory Depression Associated with Neuraxial Opioid Administration. Anesthesiology. 2016;124;535-52. doi: 10.1097/ALN.0000000000000975.
27. Taufen A. 13 ways you can improve patient safety. Medical Group Management Association. March 2012. [consultado em Agosto 2018] Disponivel em: http://www.inpracticemanagement.com/ckfinder/userfiles/files/March%202012%20Newsletter.pdf
28. Love BL, Jensen LA, Schopflocher D, Tsui BCh. Development of an electronic database for Acute Pain Service outcomes. Pain Res Manag. 2012;1:25-30.
29. Direção Geral da Saúde. Circular Normativa Nº 09/DGCG de 14/06/2003. A Dor como 5º sinal vital - Registo sistemático da intensidade da Dor. Lisboa: DGS; 2003.
30. Ministério da Saúde. Diário da República, 2.ª série, n.º 36. Despacho nº2784. 20 de Fevereiro de 2013.
31. Goldstein DH, Phelan R, Wilson R, Ross-White A, VanDenKerkhof EG, Penning JP, et al. Brief review: adoption of electronic medical records to enhance acute pain management. Can J Anesth. 2014;61:164-79.
32. Medical Protection Society. An essential guide to medical records-advice for the United Kingdom. [consultado Dez 2017]. Disponível em: https://www.medicalprotection.org/uk/articles/an-mps-essential-guide-to-medical-records
33. Procuradoria Geral Distrital de Lisboa. Lei nº 12/2005 de 26 de Janeiro - Informação genética pessoal e informação de saúde.
34. Comissão Nacional de Proteção de Dados. Regulamento Geral de Proteção de Dados Lisboa: RGPD; 2018.
35. National Institute for clinical excellence, NHS CHI. Royal College of Nursing. University of Leicester. Principles for best practice in clinical audit [consultado em Agosto 2018] Disponível em: http://www.nice.org.uk/media/796/23/BestPracticeClinicalAudit.pdf
36. Kötter T, Blozik E, Scherer M. Methods for the guideline-based development of quality indicators – a systematic review. Implement Sci. 2012 ; 7:21. doi: 10.1186/1748-5908-7-21.
37. Wollersheim H, Hermens R, Hulscher M, Braspenning J, Ouwens M, Schouten J, et al. Clinical indicators: development and applications. Neth J Med. 2007;65:15-22.
38. Royal College of Anaesthetists. Raising the Standard: a compendium of audit recipes. In: Vickers A, Grady K, editors. Section 11: Pain Medicine. 3rd ed. London: Royal College of Anaesthetists; 2012. p 291-341.
39. Mainz J. Defining and classifying clinical indicators for quality improvement. Int J Qual Health Care. 2003;15:523-30.
40. Societal Impact of Pain: Quality indicators of chronic pain management Rolf-Detlef Treede. [consultado Julho 2018] Disponível em: https://www.sip-platform.eu/resources?page=67
41. SINAS – Sistema Nacional de Avaliação em Saúde – Melhores cuidados, melhores resultados. Manual de especificações – Avaliação da Dor Aguda. Lisboa: SINAS;2017.
42. Australasian Clinical Indicator Report 2009-2016.18th ed.. Anaesthesia and perioperative care version. Melbourne: ACIR; 2017.
43. The American Society of Anesthesiologists. Practice Guidelines for Acute Pain Management in the perioperative setting. Anesthesiology. 2012; 116: 248-73. doi: 10.1097/ALN.0b013e31823c1030.
44. Joint Commission on Accreditation of Healthcare Organizations, JCAHO. Improving the Quality of Pain Management Through Measurement and Action. [consultado em Agosto 2018] Disponível em: https://www.npcnow.org/system/files/research/download/Improving-the-Quality-of-Pain-Management-
Through-Measurement-and-Action.pdf
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Published
2019-06-04
How to Cite
Valente, R. F., Carmona, C., Serralheiro, I., Monteiro, M., Gomes, P., Santos, R., & Fonseca, S. (2019). Portuguese Society of Anesthesiology Recommendations for the Treatment of Acute Pain 2018. Journal of the Portuguese Society of Anesthesiology, 28(2), 102–109. https://doi.org/10.25751/rspa.15020
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Consensus
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