Acute pain services in India: A glimpse of the current scenario

Abstract

Background and Aims:Acute postoperative pain is still a neglected and unresolved issue in day to day practice. Acute pain services were conceived three decades ago to form a dedicated team to monitor pain assessment and treatment as per laid down pain protocols and guidelines. The concept of acute pain service (APS) is slowly evolving in India.Material and Methods:This nationwide questionnaire survey was conducted to identify the status of postoperative pain, the prevalent treatment practices, and the prevalence of acute pain services in India. An electronic communication was sent to 4000 Indian Society of Anesthesiologists life members.Results:We received only 146 responses mainly from faculties/consultants from few corporate hospitals or medical colleges. About 68 APSs were functioning, however, 20 APS do not have any training programs and 34 have no written protocols. Anesthesiologists were involved in postoperative pain management only when epidural analgesia was employed.Conclusion:This survey found that majority of anesthesiologists agree to establish an APS, however administrative issues seem to be a major barrier.

A multicentre survey of the current acute post-operative pain management practices in tertiary care teaching hospitals in Maharashtra

“…The 24-item questionnaire was designed on the basis of the questionnaire surveys done before,[910111213141516171819] to get a comprehensive idea about the existing acute pain management practices and availability of APS. An APS is a rapidly evolving health-care service for managing post-operative pain which may also be tasked with consultation related to non-surgical pain like trauma, burns and other cases.…”

“…An APS is a rapidly evolving health-care service for managing post-operative pain which may also be tasked with consultation related to non-surgical pain like trauma, burns and other cases. [920] Besides the post-operative pain, treatment for non-surgical pain was provided by anaesthesiologists in 13 hospitals out of 30, on request by surgeons, irrespective of the presence of APS.…”

“…The observation that there is a paucity of APS in Maharashtra is a reflection of a previous national level survey by Jain et al . [9] in which it was observed that there were only 68 functioning APS in India. The advantages of having an APS are an improvement in the quality of pain management and lower incidence of side effects.…”

“…The other reasons were lack of equipment (86.7%), workforce (83.3%), concerns regarding affordability of patients (80%), difficulty in procuring opioids (76.6%), lack of priority from hospital administration (63.3%), etc., This is a very important take-home message of this study as it provides directions for improvement in the area of post-operative pain management. In the national survey by Jain et al .,[9] lack of initiative and funds were the major reasons cited by the anaesthesiologists. In this study,[9] 'lack of pain education' as a hurdle in starting APS was not included.…”

“…In the national survey by Jain et al .,[9] lack of initiative and funds were the major reasons cited by the anaesthesiologists. In this study,[9] 'lack of pain education' as a hurdle in starting APS was not included. However, it has been cited as one of the biggest hurdles in pain management in our study.…”