Pain Assessment

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Pain Assessment

• Dr Leon Malzinskas
• SMO BCRH Wonthaggi Hospital

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Pain Definition

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

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Post operative pain

• Acute
• Nociceptors and Neuropathic pain
• Surgical pain

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Why is control important

• Delays post op recovery
• Increases morbidity
• Delays return to normal function
• Restricts mobility -gt thromboembolism
• Catecholamine release
• Pulmonary dysfunction

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Assessment

• Pre op prediction
• Post op subjective assessment
• Post op objective assessment

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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

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Subjective assessment

• Pain scales - single dimensional and multi
  dimensional

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Objective

• Look at the patient
• Physiological parameters
• Functional parameters

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Outcomes assessment

• Response to therapy

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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

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Summary

• Preop assessment
• Knowledge of surgery
• Simple and quick assessment tools
• Outcome assessment regularly