ASA Practice Guidelines for Acute Pain Management in the Perioperative Setting

 ASA revised the acute pain management guidelines.
These guidelines didn't change but the evidence for recommendations did.

The updated guidelines are published in Anesthesiology February issue.

Here we are presenting the Summary of these guidelines....

1-Concerning perioperative pain management, institutions should provide education and training for healthcare providers, monitor pain management outcomes, document monitoring used for pain management, have anesthesiologists available at all hours, and have a dedicated pain management service.
Training for healthcare providers is associated with better pain control, greater patient satisfaction, and less nausea and vomiting.

2-Pain management should be planned preoperatively. Patient medications should be reviewed in part since a withdrawal syndrome can result if certain medications are stopped. Treatment to reduce pain and anxiety preoperatively should be considered.In addition, patients and their families can receive education preoperatively, including behavioral therapy on managing postoperative pain.Patient education can include an explanation of how to best use patient-controlled analgesia (PCA), including, if used, patient-controlled epidural analgesia.

3-Different techniques that can be used to manage postoperative pain include the use of neuroaxial opioid analgesics, PCA, and peripheral regional analgesic techniques. Since there are risks and benefits associated with each of these techniques, the optimal technique should be considered on an individual basis for patients.

4-Pain management can be more effective if the combined use of different drugs that act at different sites or by different mechanisms, administered either by the same or different routes, should be considered.

5-Pain management of children, older patients, and critically ill or cognitively impaired patients deserves special attention. For these different groups, pain is frequently under treated and these individuals may have difficulty communicating to caregivers that they are in pain. Children can have emotional components to their pain and these should be considered. Certain aspects of pain management are no different for children or adults, though caudal analgesia is more commonly used for children. Older and critically ill patients may need lower drug doses for pain management than younger patients.

To access the guidelines press on the following link...

                                        ASA guidelines-Anesthesiology February issue