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.
- Gives comprehensive cover of all of the areas of importance in the management of acute pain
- Presents highly practical information firmly supported by full evaluation of the scientific literature
- Concisely written text supplemented with useful checklists, flow charts and key points that can be readily referred to during treatment of a patient
- Gives a series of acute pain management plans, whilst at the same time discussing controversial areas and possible solutions
- Explores pain control in complex cases – opioid-tolerant patients, pregnant and lactating patients, patients with hepatic and renal impairment and the elderly
- Discusses the important areas of acute neuropathic pain and the transition from acute to persistent pain
- Key self-assessment questions and answers
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
- No. of pages:
- © Saunders 2007
- 27th July 2007
- Paperback ISBN:
Director, Acute Pain Service, Department of Anesthesia, Hyperbaric Medicine and Pain Medicine, Royal Adelaide Hospital and University of Adelaide, Adelaide, Australia
Stephan Schug is a medical graduate from the University of Cologne in Germany. At this University he also completed his MD by thesis in clinical pharmacology and his specialist training in anaesthesia, intensive care and pain medicine. After working for the University of Cologne as a Clinical Lecturer and Co-Director of its Cancer Pain Management Center, he moved to Auckland, New Zealand in 1989.
In Auckland, he worked initially for Auckland Hospital as a Temporary Acting Specialist in Anaesthesia and Pain Medicine, before joining the Pharmacology Department of the University of Auckland as a Senior Lecturer and Head of its Section of Anaesthetics in 1991. He was promoted to Associate Professor in 1994 and became full Professor and the first Chair of Anaesthesiology of the University of Auckland in 2000. Throughout his 12 years in Auckland, Stephan Schug had a clinical role as a staff specialist in anaesthesia and pain medicine at Auckland Hospital and the inaugural director of its pain service.
When Stephan Schug moved to Perth in 2001, he maintained his linkage to the University of Auckland as an Honorary Professor of Anaesthesiology, while taking up his new role as Associate Professor, then Professor in the Pharmacology Unit of the School of Medicine and Pharmacology of the University of Western Australia. In 2006, he succeeded Professor Teik Oh, the Inaugural Chair of Anaesthesia at UWA, who retired. Stephan Schug's clinical role is Director of Pain.
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