Perioperative pain management is the management of the patient in pain around three major phases that are preoperative phase, intraoperative phase, and post-operative phase (Russo, Parks and Hamilton 2017). This journal entry is a reflective analysis of perioperative management for the patient John (Pseudonym) who was being prepared for the surgery.
John underwent the surgery due to multiple fractures followed by a serious accident. He was administered anesthesia before his surgical procedure and was then shifted to PACU for the proper assessment. After the completion of his surgical procedure, he was in pain and was in extreme discomfort due to higher pain levels.
The process of perioperative pain management initiated before the surgery and the same was continued even after the surgery (Joshi et al. 2017). Regional anesthesia is given to the patients before the onset of surgical actions and procedures. It is extensively used as a primary anesthetic method for operation (Greimel et al. 2017). Anaesthetic is used as an analgesic modality that works for pain management in the perioperative period. Perioperative pain management is done initially by injecting anesthesia that also assists in postoperative pain management (Vittinghoff et al. 2018). Regional analgesia performs the best while the patient is under general anesthesia and this works the best in postoperative pain management (Kumar, Kirksey, Duong and Wu 2017).
As an observing student nurse, I learned that the perioperative pain management can be best done with the combination of general anesthesia followed by the regional analgesia that will have a positive impact on the patient’s early mobility, improving the comfort level and reduced risk of complications. The anaesthesia was given as a pain management in PACU but he was in severe pain in PACU because he was given only pre-operative anesthesia. This experience added to my learning that the patient’s fastest recovery is highly associated with the perioperative pain management technique. I will use the learnings from this experience in the future that will help me improve my nursing practice related to the pain management.
Greimel, F., Maderbacher, G., Zeman, F., Grifka, J., Meissner, W. and Benditz, A., 2017. No clinical difference comparing general, regional, and combination anesthesia in hip arthroplasty: a multicenter cohort-study regarding perioperative pain management and patient satisfaction. The Journal of Arthroplasty, vol. 32, no. 11, pp.3429-3433.
Joshi, G.P., Kehlet, H., Beloeil, H., Bonnet, F., Fischer, B., Hill, A., Lavandhomme, P.M., Lirk, P., Pogatzki-Zhan, E.M., Raeder, J. and Rawal, N., 2017. Guidelines for perioperative pain management: need for re-evaluation. BJA: British Journal of Anaesthesia, vol. 119, no. 4, pp.703-706.
Kumar, K., Kirksey, M.A., Duong, S. and Wu, C.L., 2017. A review of opioid-sparing modalities in perioperative pain management: methods to decrease opioid use postoperatively. Anesthesia& Analgesia, vol. 125, no.5, pp.1749-1760.
Russo, M.W., Parks, N.L. and Hamilton, W.G., 2017. Perioperative Pain Management and Anesthesia: A Critical Component to Rapid Recovery Total Joint Arthroplasty. The OrthopedicClinics of North America, vol. 48, no. 4, pp.401.
Vittinghoff, M., Lönnqvist, P.A., Mossetti, V., Heschl, S., Simic, D., Colovic, V., Dmytriiev, D., Hölzle, M., Zielinska, M., Kubica‐Cielinska, A. and Lorraine‐Lichtenstein, E., 2018. Postoperative pain management in children: Guidance from the pain committee of the European Society for Paediatric Anaesthesiology (ESPA Pain Management Ladder Initiative). PediatricAnesthesia, vol. 28, no. 6, pp.493-506.
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