Pain AssessmentDr Leon Malzinskas

SMO BCRH Wonthaggi Hospital

Pain Definition

• Sensory and emotional experience associated with actual or potential tissue damage

Post operative pain

• Acute

• Nociceptors and Neuropathic pain

• Surgical pain

Why is control important

• Delays post op recovery

• Increases morbidity

• Delays return to normal function

• Restricts mobility -> thromboembolism

• Catecholamine release

• Pulmonary dysfunction

Assessment

• Pre op prediction

• Post op subjective assessment

• Post op objective assessment

Pre op assessment

• Past medical and surgical history

• Current Rx (prescribed and illicit)

• Allergies

• Past pain history and treatments

• Patients expectations of pain

• Advice re pain Mx and modes of delivery

• How we measure pain and patients reporting

Subjective assessment

• Pain scales - single dimensional and multi dimensional

Objective

• Look at the patient

• Physiological parameters

• Functional parameters

Outcomes assessment

• Response to therapy

Practicalities

• Pre op assessment

• Prediction of pain

• Preempt with preventative Rx

• Assess post op subjectively and objectively

• Treat with appropriate Rx

• Assess response

• Modify Mx

Summary

• Preop assessment

• Knowledge of surgery

• Simple and quick assessment tools

• Outcome assessment regularly