Pharmacist educational intervention in intravenous patient controlled analgesia in associated with decreased postoperative pain
Corresponding Author(s) : K. Sindhu
sindukarankot@gmail.com
International Journal of Allied Medical Sciences and Clinical Research,
Vol. 6 No. 1 (2018): 2018 Volume 6- Issue -1
Abstract
Education may be provided by any healthcare professional who has undertaken appropriate training education, education on patient communication and education is usually included in the healthcare professional's training. One of the most obvious problems a person has to deal with after surgery is pain. There are many reasons why it is important to treat pain after surgery adequately and promptly. This study was conducted to compare the clinical efficacy and adverse effects of multimodal analgesic regimen of morphine and Ibuprofen combined with ketorolac using IV PCA, and to study the effect of structured preoperative educational program on analgesic efficacy, incidence of adverse effects, and patients` satisfaction. Categorical data and proportions were analyzed using the ?2 test or the Fisher’s exact test as required. Student’s t test was used to compare the Physician-Pharmacist Co management of Postoperative means of the 2 groups with normal distributions, and the Mann-Whitney U test was used to compare variables with non-normal distributions. All tests were 2-tailed, P value < 0.05 was considered statistically significant. Morphine provides more effective postoperative analgesia than Ibuprofen when coadministered with ketorolac. The combination of ketorolac allowed more pronounced synergistic effect with morphine than that with Ibuprofen. Preoperative patient and nurse education improved analgesia and overall patient satisfaction with their pain treatment protocol; the patient can treat pain more in a more timely and individualized manner, thus, increasing pain-management satisfaction
Keywords
Ketorolac
Mann-Whitney U test
Physician-Pharmacist
1.
K. Sindhu. Pharmacist educational intervention in intravenous patient controlled analgesia in associated with decreased postoperative pain. Int. J. of Allied Med. Sci. and Clin. Res. [Internet]. 2020 Aug. 10 [cited 2025 Sep. 26];6(1):128-37. Available from: https://ijamscr.com/ijamscr/article/view/491
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References
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Stadler M, et al. A cost-utility and cost-effectiveness analysis of an acute pain service. J ClinAnesth. 16,2004,159-167. [2]. Wheatley RG, et al. The first years’ experience of an acute pain service. Br J Anaesth. 67,1991,353-359. [3]. Barrington JW, et al. Expert working group on anesthesia and orthopaedics critical issues in hip and knee replacement arthroplasty FT. Perioperative pain management in hip and knee replacement surgery. Am J Orthop (Belle Mead NJ). 43, 2014, 1-16. [4]. American Society of Anesthesiologists Task Force on Acute Pain Management. Practice guidelines for acute pain management in the perioperative setting: An updated report by the American Society of Anesthesiologists Task Force on Acute Pain Management. Anesthesiology.116, 2012, 248-273. [5]. Low SJ, et al. An audit of changes in outcomes of acute pain service: Evolution over the last 2 decades. Medicine (Baltimore). 94, 2015, e1673. [6]. Smith T, et al. Antimicrobial stewardship in a community hospital: attacking the more difficult problems. Hosp Pharm.â€Â49, 2014, 839-846. [7]. Prado MA, et al. The implementation of a surgical antibiotic prophylaxis program: The pivotal contribution of the hospital pharmacy. Am J Infect Control. 30,2002,49-56. [8]. Mularski KS, et al. Pharmacist glycemic control team improves quality of glycemic control in surgical patients with perioperative dysglycemia. Perm J. 16, 2012, 28-33.
Uma M et al / Int. J. of Allied Med. Sci. and Clin. Research Vol-6(1) 2018 [128-137]
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[9]. Maheshwari AV, et al. Multimodal pain management after total hip and knee arthroplasty at the RanawatOrthopaedic Center. ClinOrthopRelat Res. 467, 2009, 1418-1423. [10]. Dickerson DM. Acute pain management. Anesthesiol Clin. 32, 2014, 495-504. [11]. Thomazeau J, et al. Acute pain factors predictive of post-operative pain and opioid requirement in multimodal analgesia following knee replacement. Eur J Pain. 12, 2016, 822-832. [12]. Skinner HB. Multimodal acute pain management. Am J Orthop (Belle Mead NJ). 33, 2004, 5-9. [13]. Kehlet H and Holte K. Effect of postoperative analgesia on surgical outcome. Br J Anaesth. 87,2001,62-72. [14]. Prabhakar A, et al. Perioperative analgesia outcomes and strategies. Best Pract Res ClinAnaesthesiol. 28,2014,105-115. [15]. Wang YC, et al. Patient-machine interactions of intravenous patient-controlled analgesia in bilateral versus unilateral total knee arthroplasty: A retrospective study. J Chin Med Assoc. 76, 2013, 330-334. [16]. Danninger T, et al. Perioperative pain control after total knee arthroplasty: An evidence based review of the role of peripheral nerve blocks. World J Orthop. 5, 2014, 225-232. [17]. Nishio S, et al. Comparison of continuous femoral nerve block, caudal epidural block, and intravenous patient-controlled analgesia in pain control after total hip arthroplasty: A prospective randomized study. Orthop Rev (Pavia). 6:5138, 2014, 15-19. [18]. Chumbley GM, et al. Patient-controlled analgesia: an assessment by 200 patients. Anaesthesia. 53,1998,216-221. [19]. Patak LS, et al. Patient perspectives of patient-controlled analgesia (PCA) and methods for improving pain control and patient satisfaction. RegAnesth Pain Med. 38, 2013, 326-333. [20]. Mercadante S. Intravenous patient-controlled analgesia and management of pain in post-surgical elderly with cancer. SurgOncol. 19, 2010, 173-177.
References
Stadler M, et al. A cost-utility and cost-effectiveness analysis of an acute pain service. J ClinAnesth. 16,2004,159-167. [2]. Wheatley RG, et al. The first years’ experience of an acute pain service. Br J Anaesth. 67,1991,353-359. [3]. Barrington JW, et al. Expert working group on anesthesia and orthopaedics critical issues in hip and knee replacement arthroplasty FT. Perioperative pain management in hip and knee replacement surgery. Am J Orthop (Belle Mead NJ). 43, 2014, 1-16. [4]. American Society of Anesthesiologists Task Force on Acute Pain Management. Practice guidelines for acute pain management in the perioperative setting: An updated report by the American Society of Anesthesiologists Task Force on Acute Pain Management. Anesthesiology.116, 2012, 248-273. [5]. Low SJ, et al. An audit of changes in outcomes of acute pain service: Evolution over the last 2 decades. Medicine (Baltimore). 94, 2015, e1673. [6]. Smith T, et al. Antimicrobial stewardship in a community hospital: attacking the more difficult problems. Hosp Pharm.â€Â49, 2014, 839-846. [7]. Prado MA, et al. The implementation of a surgical antibiotic prophylaxis program: The pivotal contribution of the hospital pharmacy. Am J Infect Control. 30,2002,49-56. [8]. Mularski KS, et al. Pharmacist glycemic control team improves quality of glycemic control in surgical patients with perioperative dysglycemia. Perm J. 16, 2012, 28-33.
Uma M et al / Int. J. of Allied Med. Sci. and Clin. Research Vol-6(1) 2018 [128-137]
137
[9]. Maheshwari AV, et al. Multimodal pain management after total hip and knee arthroplasty at the RanawatOrthopaedic Center. ClinOrthopRelat Res. 467, 2009, 1418-1423. [10]. Dickerson DM. Acute pain management. Anesthesiol Clin. 32, 2014, 495-504. [11]. Thomazeau J, et al. Acute pain factors predictive of post-operative pain and opioid requirement in multimodal analgesia following knee replacement. Eur J Pain. 12, 2016, 822-832. [12]. Skinner HB. Multimodal acute pain management. Am J Orthop (Belle Mead NJ). 33, 2004, 5-9. [13]. Kehlet H and Holte K. Effect of postoperative analgesia on surgical outcome. Br J Anaesth. 87,2001,62-72. [14]. Prabhakar A, et al. Perioperative analgesia outcomes and strategies. Best Pract Res ClinAnaesthesiol. 28,2014,105-115. [15]. Wang YC, et al. Patient-machine interactions of intravenous patient-controlled analgesia in bilateral versus unilateral total knee arthroplasty: A retrospective study. J Chin Med Assoc. 76, 2013, 330-334. [16]. Danninger T, et al. Perioperative pain control after total knee arthroplasty: An evidence based review of the role of peripheral nerve blocks. World J Orthop. 5, 2014, 225-232. [17]. Nishio S, et al. Comparison of continuous femoral nerve block, caudal epidural block, and intravenous patient-controlled analgesia in pain control after total hip arthroplasty: A prospective randomized study. Orthop Rev (Pavia). 6:5138, 2014, 15-19. [18]. Chumbley GM, et al. Patient-controlled analgesia: an assessment by 200 patients. Anaesthesia. 53,1998,216-221. [19]. Patak LS, et al. Patient perspectives of patient-controlled analgesia (PCA) and methods for improving pain control and patient satisfaction. RegAnesth Pain Med. 38, 2013, 326-333. [20]. Mercadante S. Intravenous patient-controlled analgesia and management of pain in post-surgical elderly with cancer. SurgOncol. 19, 2010, 173-177.
Uma M et al / Int. J. of Allied Med. Sci. and Clin. Research Vol-6(1) 2018 [128-137]
137
[9]. Maheshwari AV, et al. Multimodal pain management after total hip and knee arthroplasty at the RanawatOrthopaedic Center. ClinOrthopRelat Res. 467, 2009, 1418-1423. [10]. Dickerson DM. Acute pain management. Anesthesiol Clin. 32, 2014, 495-504. [11]. Thomazeau J, et al. Acute pain factors predictive of post-operative pain and opioid requirement in multimodal analgesia following knee replacement. Eur J Pain. 12, 2016, 822-832. [12]. Skinner HB. Multimodal acute pain management. Am J Orthop (Belle Mead NJ). 33, 2004, 5-9. [13]. Kehlet H and Holte K. Effect of postoperative analgesia on surgical outcome. Br J Anaesth. 87,2001,62-72. [14]. Prabhakar A, et al. Perioperative analgesia outcomes and strategies. Best Pract Res ClinAnaesthesiol. 28,2014,105-115. [15]. Wang YC, et al. Patient-machine interactions of intravenous patient-controlled analgesia in bilateral versus unilateral total knee arthroplasty: A retrospective study. J Chin Med Assoc. 76, 2013, 330-334. [16]. Danninger T, et al. Perioperative pain control after total knee arthroplasty: An evidence based review of the role of peripheral nerve blocks. World J Orthop. 5, 2014, 225-232. [17]. Nishio S, et al. Comparison of continuous femoral nerve block, caudal epidural block, and intravenous patient-controlled analgesia in pain control after total hip arthroplasty: A prospective randomized study. Orthop Rev (Pavia). 6:5138, 2014, 15-19. [18]. Chumbley GM, et al. Patient-controlled analgesia: an assessment by 200 patients. Anaesthesia. 53,1998,216-221. [19]. Patak LS, et al. Patient perspectives of patient-controlled analgesia (PCA) and methods for improving pain control and patient satisfaction. RegAnesth Pain Med. 38, 2013, 326-333. [20]. Mercadante S. Intravenous patient-controlled analgesia and management of pain in post-surgical elderly with cancer. SurgOncol. 19, 2010, 173-177.