Acute Pain Management - Rights Reverted

A Practical Guide


  • Pamela Macintyre, BMedSc, MBBS, MHA, FANZCA, FFPMANZCA, Director, Acute Pain Service, Department of Anesthesia, Hyperbaric Medicine and Pain Medicine, Royal Adelaide Hospital and University of Adelaide, Adelaide, Australia
  • Stephan Schug, MD, FANZCA, FFPMANZCA, Chair of Anaesthesiology, Pharmacology and Anaesthesiology Unit, School of Medicine and Pharmacology, University of Western Australia; Director of Pain Medicine, Royal Perth Hospital, Perth, Australia

This is a new edition of a highly successful practical guide to acute pain management in the adult patient. The book provides a clear understanding of the current methods of analgesia for all those involved in the pain management team: trainees, residents, practicing anaesthetists and intensivists, junior doctors and nurses.
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Junior medical staff, nursing staff and medical and nursing students


Book information

  • Published: July 2007
  • Imprint: SAUNDERS
  • ISBN: 978-0-7020-2770-3

Table of Contents

INTRODUCTION Effectiveness of acute pain management; Adverse effects of undertreated severe acute pain; Acute pain management and patient outcomes

ORGANIZATIONAL CONSIDERATIONS: Education Standardization; Acute pain services

ASSESSMENT OF THE PATIENT WITH ACUTE PAIN: Assessment of pain and pain relief; Assessment of adverse effects

PHARMACOLOGY OF OPIOIDS: Mechanisms of action; Effects of opioids; Predictors of opioid dose; Titration of opioid dose; Commonly used opioid agonists; Partial agonists and agonist-antagonists; Opioid antagonists

PHARMACOLOGY OF LOCAL ANESTHETIC DRUGS: Mechanism of action; Efficacy of local anesthetic drugs; Adverse effects of local anesthetic drugs; Commonly used local anesthetic drugs

NON-OPIOID AND ADJUVANT ANALGESIC AGENTS: paracetamol (acetaminophen); Non-selective non-steroidal anti-inflammatory drugs; Selective COX-2 inhibitors; Nitrous oxide; NMDA receptor antagonist drugs; alpha 2-Adrenergic agonist drugs; Calcitonin; Antidepressant drugs; Anticonvulsant drugs; Membrane-stabilizing drugs

ROUTES OF SYSTEMIC OPIOID ADMINISTRATION: Oral route; Intramuscular and subcutaneous routes; Intravenous route; Rectal route; Transdermal route; Transmucosal routes

PATIENT-CONTROLLED ANALGESIA: Equipment Analgesic and other drugs used with PCA; The PCA 'prescription'; Requirements for the safe management of PCA; Management of inadequate analgesia; 'Step-down' analgesia; Complications of PCA; Alternative systemic routes of PCA administration

EPIRURAL AND INTRATHECAL ANALGESIA: Anatomy; Contraindications; Drugs used for epidural analgesia; Requirements for the safe management of epidural analgesia; Patient-controlled epidural analgesia; Management of inadequate analgesia; 'Step-down' analgesia; Complications and side effects of epidural analgesia; Concurrent anticoagulant or antiplatelet medications; Intrathecal analgesia

OTHER REGIONAL AND LOCAL ANALGESIA: Continuous peripheral nerve blockade; Intra-articular analgesia; Wound infiltration; Topical analgesia

NON-PHARMACOLOGICAL THERAPIES: Psychological interventions; Transcutaneous electrical nerve stimulation; Acupuncture; Physical interventions

ACUTE NEUROPATHIC AND PERSISTENT POSTACUTE PAIN: Pathophysiology of neuropathic pain; Clinical features of neuropathic pain; Acute neuropathic pain syndromes; Treatment of acute neuropathic pain; Progression of acute to persistent pain; Preventive analgesia

NON-SURGICAL ACUTE PAIN: Burns injury; Spinal cord injury; Specific medical conditions

MORE COMPLEX PATIENTS: Elderly patients; Opioid-tolerant patients; Patients with a substance abuse disorder; Patients with obstructive sleep apnea; Pregnant or lactating patients; Patients with renal or hepatic impairment