1. Post-operative pain management: transition from epidural to oral analgesia
- Author
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Alexandra Beck, Olga O’Neill, and Donna Brown
- Subjects
Adult ,medicine.medical_specialty ,Nursing Records ,Analgesic ,Nursing assessment ,Administration, Oral ,Drug Administration Schedule ,Fentanyl ,Patient satisfaction ,Pain assessment ,medicine ,Humans ,Anesthetics, Local ,Intensive care medicine ,Nursing Assessment ,Pain Measurement ,Postoperative Care ,Bupivacaine ,Pain, Postoperative ,business.industry ,Nursing Audit ,General Medicine ,Continuity of Patient Care ,Discontinuation ,Analgesia, Epidural ,Analgesics, Opioid ,Treatment Outcome ,Nursing Evaluation Research ,Opioid ,Patient Satisfaction ,Practice Guidelines as Topic ,Drug Therapy, Combination ,Analgesia ,business ,medicine.drug - Abstract
Although managing pain in the acute surgical setting is a priority, there is a dearth of evidence to guide clinicians on how best to approach the discontinuation and transition of patients from epidural analgesia to oral analgesia post-operatively. This article describes an audit at a regional trust which examined data on patients' observations charts, as well as patients' self-reports of pain. The authors found that reducing epidural opioid concentrations post-operatively is useful in analgesic transition, using bupivacaine only for weaning has limited value, and that the timing of oral analgesia administration is important. They conclude that comprehensive pain assessment and better documentation are necessary to improve pain management practices. While the results demonstrate the advantage of reducing epidural opioid concentrations, decisions should be based on the needs of individual patients and not form part of a routine task.
- Published
- 2007
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