Establishing a nurse-based, anesthesiologist-supervised inpatient acute pain service: Experience of 4,617 patients

Study objective To describe our nurse-based Acute Pain Services (APS) and present the results of 4617 patients treated by our service. Design Descriptive audit. Setting Large referral hospital. Patients 4617 patients treated by the APS. Measurement and main results Analgesic regimens [basic pain treatment, patient-controlled analgesia (PCA), epidural analgesia, spinal analgesia, and wound instillation], as well as the associated patient monitoring and event-response algorithms are detailed. The mean visual analog score (VAS) for pain was low. A VAS for pain greater than 30 mm was noted in 15.3% of all pain scores recorded. Bradypnea (respiratory rate < 10 breaths/min) was recorded in 19 patients (overall incidence = 0.4%). No complications resulting in sustained morbidity or mortality occurred. Of the patients, 96% described their overall satisfaction with the APS as either good or excellent. Conclusion A nurse-based APS provides effective and safe postoperative pain management.