PMID- 10624644
OWN - NLM
STAT- MEDLINE
DA  - 20000201
DCOM- 20000201
LR  - 20061115
IS  - 0952-8180 (Print)
IS  - 0952-8180 (Linking)
VI  - 11
IP  - 7
DP  - 1999 Nov
TI  - Effectiveness of an acute pain service inception in a general hospital.
PG  - 583-9
AB  - STUDY OBJECTIVES: To assess the effects of an Acute Pain Service (APS) inception 
      on postoperative pain management in a general teaching hospital using pain
      indicators as performance measures. DESIGN: Open, prospective, nonrandomized,
      observational study. SETTING: Postanesthesia Care Unit, surgical wards of
      University Hospital Center of Charleroi. PATIENTS: 1304 patients in the pre-APS
      inception phase and 671 patients after its implemention who have undergone
      various types of surgery (orthopedics, gynecology, urology, neurosurgery,
      stomatology, ear, nose, and throat, ophthalmic, abdominal, vascular-thoracic,
      plastic, and maxillofacial). INTERVENTIONS: An APS, nurse-based,
      anesthesiologist-supervised model was devised, based on the concept that
      postoperative pain relief can be greatly improved by providing in-service
      training for surgical nursing staff and optimal use of systemic analgesics.
      MEASUREMENTS AND MAIN RESULTS: Postoperative pain was assessed using a visual
      analog scale (VAS) every 4 hours for 72 hours in the two phases. Analgesic
      consumption was registered at the same time. Time-related VAS scores were
      summarized using several pain indicators. There was an overall improvement in the
      pain scores after APS inception. The differences were most pronounced, around
      50%, in patients undergoing vascular, maxillofacial, gynecologic, and urologic
      surgeries, and stomatology. Regular administration of paracetamol and
      nonsteroidal antiinflammatory drugs decreased morphine consumption in the second 
      phase. CONCLUSION: This study validates the benefits of a formal APS, using
      continuous monitoring of rest pain intensity and analgesic consumption in the
      postoperative period. Results not only support previous research findings but
      also offer outcome-based tools to evaluate current practices as compared with
      desired outcomes.
AD  - Department of Anesthesiology, University Hospital Center, Charleroi, Belgium.
FAU - Bardiau, F M
AU  - Bardiau FM
FAU - Braeckman, M M
AU  - Braeckman MM
FAU - Seidel, L
AU  - Seidel L
FAU - Albert, A
AU  - Albert A
FAU - Boogaerts, J G
AU  - Boogaerts JG
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - UNITED STATES
TA  - J Clin Anesth
JT  - Journal of clinical anesthesia
JID - 8812166
RN  - 0 (Analgesics)
RN  - 0 (Analgesics, Non-Narcotic)
RN  - 0 (Analgesics, Opioid)
RN  - 0 (Anti-Inflammatory Agents, Non-Steroidal)
RN  - 103-90-2 (Acetaminophen)
RN  - 57-27-2 (Morphine)
SB  - IM
MH  - Acetaminophen/therapeutic use
MH  - Analgesics/therapeutic use
MH  - Analgesics, Non-Narcotic/therapeutic use
MH  - Analgesics, Opioid/therapeutic use
MH  - Anesthesiology
MH  - Anti-Inflammatory Agents, Non-Steroidal/therapeutic use
MH  - Efficiency, Organizational
MH  - Female
MH  - Follow-Up Studies
MH  - *Hospitals, General/organization & administration
MH  - Hospitals, Teaching/organization & administration
MH  - Humans
MH  - Inservice Training
MH  - Intervention Studies
MH  - Male
MH  - Middle Aged
MH  - Morphine/therapeutic use
MH  - Outcome Assessment (Health Care)
MH  - *Pain Clinics/organization & administration
MH  - Pain Measurement
MH  - Pain, Postoperative/nursing/*prevention & control
MH  - Postanesthesia Nursing/education
MH  - Prospective Studies
MH  - Reproducibility of Results
MH  - Surgical Procedures, Operative/classification
MH  - Time Factors
EDAT- 2000/01/07
MHDA- 2000/01/07 00:01
CRDT- 2000/01/07 00:00
AID - S0952-8180(99)00101-4 [pii]
PST - ppublish
SO  - J Clin Anesth. 1999 Nov;11(7):583-9.