engleski

Acute pain service: a 6 year experience and reorganization in the time of COVID-19 era : abstract book

Background and aims: Due to uneven treatment of perioperative pain and inadequate pain control, in 2015 we established Acute pain service (APS) at the University Hospital Center Sestre milosrdnice in Zagreb, Croatia. The goal of this study was to asses the efficiency of acute pain service, with special regard to organisational issues and methods we used to overcome barriers in the COVID-19 era. Methods: Using available practice guidelines from NICE and pain associations we formed protocol for perioperative pain management, adapted to our organisational and financial opportunities. Two crucial elements were detailed therapeutic list using time scheduled multimodal analgesia and additional member of specialised anaesthesia nurse (APS nurse), who did regular pain assessment and consequently alterations of therapy, in consultations with on-call anaesthesiologist who performed regional anesthesia techniques. More problematic cases were handled through specialised Pain clinic. When goals of better care were reached, APS service was conducted to all surgical departments. Results: There was a satisfactory reduction of pain in more than 70% of all surgical patients, faster recovery, less opioid misuse with decreased opioid exposure and reduction of side effects. Due to COVID-19 pandemic, there was a rise in postoperative pain, which we curbed with both technological and personal modifications. There was no stoppage with therapeutic lists, but pain assessment suffered the most. Significant part was taken over by telemedicine mostly by phone or video. Conclusions: Acute pain service is adjustable, patient centred protocol, which achieves satisfactory results in postoperative pain control, provides a safer and more effective approach with great impact on postoperative recovery.

acute pain service ; pain control ; COVID-19 ; pain clinic

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