SHM's Clinical Quick Talks-Acute Inpatient Pain Management

Pdf Summary

The document titled "Acute Inpatient Pain Management" by Lily Ackermann highlights strategies in managing acute pain in a hospital setting with a focus on minimizing opioid use. Key recommendations include setting realistic pain management goals and utilizing a multimodal pain control approach to target various pain receptors. It emphasizes that complete pain elimination is unrealistic and early education to set patient expectations is crucial. <br /><br />The management of pain should begin with an assessment that includes both subjective pain scales and objective measures such as the patient’s appearance, functional status, and vital signs. For chronic pain patients, understanding their baseline pain level at home helps in setting realistic discharge expectations.<br /><br />Non-opioid pharmacotherapies like acetaminophen and NSAIDs should be prioritized. Acetaminophen, unless contraindicated, should be scheduled rather than administered as needed, improving overall effectiveness and reducing opioid dependency. NSAIDs are effective in reducing opioid use, but caution is advised in patients with certain conditions, such as those over 65 or with renal impairments. Skeletal muscle relaxants can be useful for certain surgeries but should be avoided in the elderly due to risks of dizziness.<br /><br />Opioids should be considered as a last resort, prioritizing oral over IV routes due to lower associated risks. Tramadol and other opioids with higher risk profiles are not recommended as first-line options. For patients requiring continuous opioid management, patient-controlled analgesia (PCA) is recommended for improved patient satisfaction and management of breakthrough pain, with precautions for dosing adjustments.<br /><br />The educational emphasis for caregivers is to improve patient functional status rather than eliminate pain fully, supporting harm reduction strategies to avoid opioid dependencies. The document provides resource references for further reading on best practices in pain management.

Asset Subtitle

Lily Ackermann

Keywords

acute pain management

opioid minimization

multimodal pain control

patient education

non-opioid pharmacotherapy

acetaminophen

NSAIDs

patient-controlled analgesia

pain assessment

functional status