Position Statement: Acute Perioperative Pain Management Among Patients Undergoing Orthopedic Surgery by the American Society for Pain Management Nursing and The National Association of Orthopaedic Nurses

Arkin, Laura C; Lyons, Mary; McNaughton, Molly Ann; Quinlan-Colwell, Ann

doi:10.1016/j.pmn.2022.01.006

Cited by 3 publications

(3 citation statements)

References 21 publications

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confidence: 99%

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BackgroundThe National Association of Orthopaedic Nurses and the American Society for Pain Management Nursing (ASPMN) collaborated in the development of a shared position statement for nurses titled "Acute Perioperative Pain Management Among Patients Undergoing Orthopaedic Surgery" (Arkin et al, 2022). This position article provided evidence-informed guidance for nurses caring for patients undergoing elective orthopaedic procedures.

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confidence: 99%

“…Regardless of the type, it is imperative to appropriately and optimally manage postoperative pain. Unrelieved acute pain can result in many negative sequelae, including delayed healing, increased morbidity, pulmonary complications, limited rehabilitation participation, anxiety, depression, increased length of stay, prolonged duration of opioid use, and the development of chronic pain (Arkin et al, 2022;Glare et al, 2019;Quinlan-Colwell, 2021).These concepts primarily address patients experiencing elective postoperative orthopaedic pain; however, many are applicable to nonelective and trauma situations as well. Perioperative pain in patients undergoing orthopaedic surgery is variable depending upon the personspecific characteristics, the etiology of the pain, and the procedure.…”

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Acute Perioperative Pain Management of the Orthopaedic Patient

McNaughton,

Quinlan-Colwell,

Lyons

et al. 2024

Orthopaedic Nursing

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Orthopaedic surgery often results in pain, with less than half of patients reporting adequate relief. Unrelieved acute pain occurring after surgery increases the risk of negative sequelae, including delayed healing, increased morbidity, pulmonary complications, limited rehabilitation participation, anxiety, depression, increased length of stay, prolonged duration of opioid use, and the development of chronic pain. Interventions that are individualized, evidence-informed, and applied within an ethical framework improve healthcare delivery for patients, clinicians, and healthcare organizations. Recommendations for using the principles of effective pain management from preoperative assessment through discharge are detailed, including recommendations for addressing barriers and challenges in applying these principles into clinical practice.

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Section: Introductionmentioning

confidence: 99%

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confidence: 99%

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Acute Perioperative Pain Management of the Orthopaedic Patient

McNaughton,

Quinlan-Colwell,

Lyons

et al. 2024

Orthopaedic Nursing

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Development and Implementation of an Online Pain Management Continuing Education Program

Scott-Richardson¹,

Johnson²,

McGlorthan³

et al. 2022

Pain Management Nursing

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Pain Management in Staged Osseointegration Procedures: A Retrospective Study and Foundation for Future Optimization

McCarthy,

Ariizumi,

Grajales

et al. 2024

Military Medicine

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Introduction Osseointegration is an innovative procedure to attach an external prosthetic device directly to the skeleton. The technique has been shown to improve physical function and quality of life relative to conventional socket prosthetic devices. While much of the research in osseointegration has focused on functional outcomes, less is known regarding perioperative pain management. The purpose of this study was to describe perioperative and postoperative pain management approaches received by patients undergoing osseointegration procedures at a tertiary medical center. Materials and Methods This retrospective study was determined to be exempt from Institutional Review Board review by the Walter Reed National Military Medical Center Department of Research Programs. Perioperative and postoperative pain management approaches received by 41 patients who underwent 76 staged osseointegration procedures from 2016 to 2021 at Walter Reed National Military Medical Center were described. Results Pain management approaches included perioperative ketamine (51% stage I, 55% stage II), epidurals (76% stage I, 77% stage II) with a median of 3-4 days across stages, peripheral nerve catheters (27% stage I, 16% stage II), and/or single-shot peripheral nerve block (<10% across stages). The median morphine equivalent dose provided during surgery was 65 mg across both stages, with 56% and 54% of patients also requiring opioid medication in the post-anesthesia care unit. In 11 of 76 (15%) procedures, patients required an increase in the rate or concentration of epidural or peripheral nerve catheter infusion. In six (8%) unique recovery periods, patients experienced a dislodged catheter. In 27 of 76 (36%) unique recovery periods, patients experienced a significant increase in postoperative pain requiring acute pain service intervention in the form of catheter adjustment, intravenous pain medications, and/or the addition of intravenous patient-controlled analgesia. Adequate pain control was achieved with minimal epidural or peripheral nerve catheter trouble-shooting and a bolus for 24 patients (89% requiring intervention). Summed 24-hour pain scores (SPI24) did not vary across stages. SPI24 was positively correlated with opioid doses received. Patients with single, relative to multiple, limb amputations had similar SPI24 values (P > .05). Conclusions Variability in pain management requirements calls forth opportunities to optimize osseointegration analgesia care and future research. As osseointegration becomes more accessible, the need for optimizing pain management through patient-centered research becomes more salient.

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Position Statement: Acute Perioperative Pain Management Among Patients Undergoing Orthopedic Surgery by the American Society for Pain Management Nursing and The National Association of Orthopaedic Nurses

Cited by 3 publications

References 21 publications

Acute Perioperative Pain Management of the Orthopaedic Patient

Acute Perioperative Pain Management of the Orthopaedic Patient

Development and Implementation of an Online Pain Management Continuing Education Program

Pain Management in Staged Osseointegration Procedures: A Retrospective Study and Foundation for Future Optimization

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