Hostname: page-component-78c5997874-dh8gc Total loading time: 0 Render date: 2024-11-12T19:40:31.689Z Has data issue: false hasContentIssue false

Case Study of a Patient with Acute on Chronic Pain Following Total Abdominal Hysterectomy

Published online by Cambridge University Press:  01 August 2011

Jonathan F. Dee*
Affiliation:
Recovery, Main Theatre Suite, Aberdeen Royal Infirmary, Aberdeen, UK
*
Correspondence to: J.F. Dee, Registered Nurse, Recovery, Main Theatre Suite, Aberdeen Royal Infirmary, Westburn Road, Aberdeen AB25 2ZN, UK. Tel: +44 01224 552154; E-mail: [email protected]
Get access

Abstract

The aim of this case study is to critically explore the holistic care of a patient who requires pain management in the Post Anaesthetic Care Unit (PACU). The development of chronic pain can have a significant psychological impact as well as a debilitating physical effect. The article examines pain assessment tools used in the PACU as well as barriers to their implementation. Finally, both pharmacological and non-pharmacological holistic care interventions are examined.

Type
Original Article
Copyright
Copyright © British Association of Anaesthetic and Recovery Nursing 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Allen, C, Hopewell, S, Prentice, A. Non-steroidal anti-inflammatory drugs for pain in women with endometriosis (protocol). Cochrane Database of Systematic Reviews 2004; (Issue 2): CD004753.CrossRefGoogle Scholar
Aubrun, F, Monsel, S, Langeron, O, Coriat, P, Riou, B. Postoperative titration of intravenous morphine in the elderly patient. Anesthesiology 2002; 96(1): 1723.CrossRefGoogle ScholarPubMed
Bonica, JJ. Pain terms: a list with definitions and notes on usage. Recommended by the IASP Subcommittee on Taxonomy. Pain 1979; 6(1): 249252.Google Scholar
Brown, D. Pain assessment in the recovery room. Journal of Perioperative Practice 2008; 18(11): 480489.CrossRefGoogle ScholarPubMed
Buvanendran, A, Kroin, JS. Multimodal analgesia for controlling acute postoperative pain. Current Opinion in Anesthesiology 2009; 22(5): 588593.CrossRefGoogle ScholarPubMed
Chamberlain, G, Hamilton-Fairley, D. Lecture Notes on Obstetrics and Gynaecology. London: Blackwell Science, 1999.Google Scholar
Ene, K, Nordberg, G, Sjöström, B, Bergh, I. Prediction of postoperative pain after radical prostatectomy. BMC Nursing 2008; 7(14). Retrieved 5 March 2012 from www.biomedcentral.com/1472-6955/7/14.CrossRefGoogle Scholar
Feldt, KS. The checklist of nonverbal pain indicators (CNPI). Pain Management Nursing 2000; 1(1): 1321.CrossRefGoogle ScholarPubMed
Groudine, S, Fossum, S. The use of intravenous acetaminophen in the treatment of postoperative pain. Journal of PeriAnesthesia Nursing 2011; 26(2): 7480.CrossRefGoogle ScholarPubMed
Hansen, GR, Streltzer, J. The psychology of pain. Emergency Medicine Clinics of North America 2005; 23: 339348.CrossRefGoogle ScholarPubMed
Hansen, K, Chalpe, A, Eyster, K. Management of endometriosis-associated pain. Clinical Obstetrics and Gynaecology 2010; 53(2): 439448.CrossRefGoogle ScholarPubMed
Hatfield, A, Tronson, M. The Complete Recovery Room Book, 4th edn. Oxford: Oxford University Press, 2008.CrossRefGoogle Scholar
Heath, ML, Thomas, VJ. Patient Controlled Analgesia: Confidence in Postoperative Pain Control. New York: Oxford Medical Publications, 1993.Google Scholar
Heikkinen, K, Salanterä, S, Kettu, M, Taittonen, M. Prostatectomy patients’ postoperative pain assessment in the recovery room. Journal of Advanced Nursing 2005; 52(6): 592600.CrossRefGoogle ScholarPubMed
Herr, K, Coyne, PJ, Key, T et al. . Pain assessment in the non-verbal patient: position statement with clinical practice recommendations. Pain Management Nursing 2006; 7(2): 4452.CrossRefGoogle Scholar
Huntington, A, Gilmour, G. A life shaped by pain: women and endometriosis. Journal of Clinical Nursing 2005; 14: 11241132.CrossRefGoogle ScholarPubMed
Kain, ZN, Sevarino, F, Alexander, GM, Pincus, S, Mayes, LC. Preoperative anxiety and postoperative pain in women undergoing hysterectomy: a repeated measures design. Journal of Psychosomatic Research 2000; 49(6): 417422.CrossRefGoogle ScholarPubMed
Koya-Rawlinson, C. Pain management: an adolescent scoliosis patient. Journal of Perioperative Practice 2009; 19(7): 205212.CrossRefGoogle ScholarPubMed
Krenzischek, DA, Windle, P, Mamaril, M. A survey of current perianesthesia nursing practice for pain and comfort management. Journal of PeriAnesthesia Nursing 2004; 19(3): 138149.CrossRefGoogle ScholarPubMed
Loeser, JD, Melzack, R. Pain: an overview. The Lancet 1999; 353(9164): 16071609.CrossRefGoogle ScholarPubMed
McCaffery, M. Nursing Practice Theories Related to Cognition, Bodily Pain, and Man-Environment Interactions. Los Angeles: UCLA Student Store, 1968.Google Scholar
McCaffrey, M. Nursing the Patient in Pain. London: Harper and Row, 1983.Google Scholar
McCaffery, M, Pasero, C. Pain – Clinical Manual, 2nd edn. St Louis: Mosby, 1999.Google Scholar
Macintyre, PE, Schug, SA. Acute Pain Management – A Practical Guide, 3rd edn. Philadelphia: Saunders Elsevier, 2007.Google Scholar
MaClellan, K. Management of Pain: Expanding Nursing and Health Care Practice Series. Cheltenham: Nelson Thornes Ltd, 2006.Google Scholar
Malow, RM, Olson, RE. Changes in pain perception after treatment for chronic pain. Pain 1981; 11: 6572.CrossRefGoogle ScholarPubMed
Malviya, S, Voepel-Lewis, T, Burke, C, Merkel, S, Tait, AR. The revised FLACC observational pain tool: improved reliability and validity for pain assessment in children with cognitive impairment. Paediatric Anaesthesia 2006; 16: 258265.CrossRefGoogle ScholarPubMed
Medicines and Healthcare Products Regulatory Agency (MHRA). Intravenous Paracetamol (Perfalgan): Risk of Accidental Overdose, Especially in Infants and Neonates. Drug Safety Update 2010; 3(12). Retrieved 17 May 2011 from http://www.mhra.gov.uk/Safetyinformation/DrugSafetyUpdate/CON088171.Google Scholar
Melzack, R, Wall, PD. The Challenge of Pain, 2nd edn. London: Penguin Books Ltd, 1988.Google Scholar
Merskey, H, Bogduk, N. Classification of Chronic Pain: Descriptions of Chronic Pain Syndromes and Definitions of Pain Terms, 2nd edn. Seattle: IASP Press, 1994.Google Scholar
O'Hara, P. Pain Management for Health Professionals. London: Chapman & Hall, 1996.Google Scholar
Odhner, M, Wegman, D, Freeland, N, Steinmetz, A, Ingersoll, GL. Assessing pain in nonverbal critically ill adults. Dimensions of Critical Care Nursing 2003; 22(6): 260267.CrossRefGoogle ScholarPubMed
Parsons, G, Preece, W. Principles and Practice of Managing Pain: A Guide for Nurses and Allied Health Professionals. Maidenhead: Open University Press, 2010.Google Scholar
Pasero, C, McCaffery, M. Reversing respiratory depression with Naloxone. American Journal of Nursing 2000; 2(2): 26.Google Scholar
The Practice Committee of the American Society for Reproductive Medicine. Treatment of pain associated with endometriosis. Fertility and Sterility 2008; 90(Supplement 3): S260S269.CrossRefGoogle Scholar
Rawal, N., ed. Management of Acute and Chronic Pain. Chichester: Wiley-Blackwell, 1998.Google Scholar
Shaw, S. Nursing and supporting patients with chronic pain. Nursing Standard 2006; 20(19): 6065.CrossRefGoogle ScholarPubMed
Spacek, A. Modern concepts of acute and chronic pain management. Biomedicine & Pharmacotherapy 2006; 60: 329335.CrossRefGoogle ScholarPubMed
Trounce, J. Clinical Pharmacology for Nurses. London: Harcourt Publishers Ltd, 2000.Google Scholar
Watt-Watson, JH, Donovan, M. Pain Management: Nursing Perspective. St Louis: Mosby Year Book Inc., 1992.Google Scholar
Wicker, P, O'Neil, J. Caring for the Perioperative Patient, 2nd edn. Chichester: Wiley-Blackwell, 2010.CrossRefGoogle Scholar
Wilding, JR, Manias, E, Mccoy, D. Pain assessment and management in patients after abdominal surgery from PACU to the postoperative unit. Journal of PeriAnesthesia Nursing 2009; 24(4): 233240.CrossRefGoogle Scholar