The Quest to Reduce Postoperative Pain

Postoperative pain remains a problem for the surgical patient, as evidenced by high pain scores and low patient satisfaction scores. The pain algorithm was developed to standardize the pain assessment process and guide the nurse in the provision of treatment options. Knowledge deficits about pain pathophysiology and attitudinal differences among caregivers can impact the appropriate use of the pain algorithm. This study identifies areas of noncompliance in the use of the algorithm so as to determine the content of educational programming with the goal of changing nursing practice. A literature review and contact with experts in the field of pain management revealed new trends in preemptive analgesia, regional blockade and complementary therapies that were not being utilized or were underutilized in the algorithm. A multidisciplinary team including anesthesia, surgeons, pharmacists and perianesthesia nurses developed a protocol for the surgical inpatient having major orthopedic and abdominal/gynecological procedures. Significantly lower pain scores were noted in PACU and up to Day 3 following the education and the implementation of the preemptive drug and spinal blockade protocol as well as the use of complementary therapies. As patient advocates, nurses must continue to educate themselves in pain management trends and protocols; they must continuously enhance pain assessment skills. Nurses must assertively collaborate with other health professionals in pursuing treatment options that lead to an optimal pain control experience for the postoperative patient.