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Monday, November 11, 2013
  Clinical Accuracy Spoken Here  

Pain Management: Chronic Pain Following Surgery

A study reviewed medical literature from 1966 through 1998. It looked at five types of surgeries. Criteria included pain that had persisted at least 12 weeks post-op. Each article examined specified a systematic collection of long term pain information. A wide variation in post-op pain was reported. Of note:

[Reference: Pain Management, Module D, Types of Chronic Pain]
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  Excellence in Case Mgmt  

Pain Management Standards and Guidelines

Case managers and others seeking to provide optimal pain relief for patients need to understand the difference among the terms used to support these efforts including Standards, Guidelines and Consensus statements.

The best choice is to use the one with the highest level of support based on the clinical needs of the patient. For example:

  • Hospitalized patient - Use Joint Commission standards
  • Management of a specific type of pain such as sickle cell - Use a guideline
  • Working with addictive patient - A position statement such as ASPMN

[Reference: Pain Management, Module B, Acute Pain]
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  Improving Patient Care...  

Pain: Barriers to Management

Overcoming barriers to the effective treatment of cancer-related pain is one of the unique characteristics of cancer pain management. The main sources of these barriers are:

  • Inadequate knowledge of pain management
  • Poor assessment of pain
  • Concern about regulation of controlled substance
  • Fear of addiction, side effects and tolerance
  • Fear of regulatory scrutiny

The American Pain Society (APS) has provided ways to overcome these barriers and proceed with effective cancer pain management.

[Reference: Pain Management, Module E, Cancer Pain]
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