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Goals and Objectives to Optimize the Value of an Acute Pain Service in Perioperative Pain Management

机译:优化围手术期疼痛管理中急性疼痛服务价值的目标和目的

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摘要

As newer pharmacologic and procedural interventions, technology, and data on outcomes in pain management are becoming available, effective acute pain management will require a dedicated Acute Pain Service (APS) to help determine the most optimal pain management plan for the patients.Goals for pain management must take into consideration the side effect profile of drugs and potential complications of procedural interventions. Multiple objective optimization is the combination of multiple different objectives for acute pain management. Simple use of opioids, for example, can reduce all pain to minimal levels, but at what cost to the patient, the medical system, and to public health as a whole?Many models for APS exist based on personnel’s skills, knowledge and experience, but effective use of an APS will also require allocation of time, space, financial, and personnel resources with clear objectives and a feedback mechanism to guide changes to acute pain medicine practices to meet the constantly evolving medical field. Physician-based practices have the advantage of developing protocols for the management of low-variability, high-occurrence scenarios in addition to tailoring care to individual patients with high-variability, low-occurrence scenarios.Frequent feedback and data collection/assessment on patient outcomes is essential in evaluating the efficacy of the Acute Pain Service’s intervention in improving patient outcomes in the acute and perioperative setting.
机译:随着更新的药物和程序干预,疼痛治疗结果的技术和数据变得可用,有效的急性疼痛管理将需要专门的急性疼痛服务(APS),以帮助确定患者的最佳疼痛治疗计划。管理必须考虑药物的副作用和程序干预的潜在并发症。多目标优化是急性疼痛管理的多个不同目标的组合。例如,简单地使用阿片类药物就可以将所有疼痛减轻到最小程度,但对患者,医疗系统以及整个公共卫生来说却要付出什么代价?存在许多基于人员技能,知识和经验的APS模型,但是有效使用APS还需要分配时间,空间,财力和人事资源,并且要有明确的目标和反馈机制,以指导急性止痛药做法的变化,以适应不断发展的医学领域。基于医师的实践的优势在于,除了针对高变异性,低发生率情况的个别患者量身定制护理外,还可以开发用于管理低变异性,高发生率情况的协议的方法。在评估急性疼痛服务在急性和围手术期改善患者预后的干预效果方面至关重要。

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