SETTING UP AND ACTIVITY OF AN ACUTE PAIN SERVICE IN A CANADIAN HOSPITAL

Objective: To describe the setting up and the activity of an acute pai n service (APS). Study design: Retrospective descriptive study includi ng two surveys among the nursing staff, the first one eight months aft er the setting up of the APS and the second one ten months later. Resu lts: In the first 19 months, 3,404 patients were treated in the APS: 1 ,456 with patient-controlled analgesia (PCA), 1,299 with epidural anal gesia, 589 with spinal opioids and 60 with continuous nerve blocks. Th e resulting overall incidence of respiratory depression was 0.7%. It r anged from 0% with continuous nerve block to 1.2% with PCA. It was at 0.3% with epidural analgesia and 0.5% with spinal opioids. Both survey s confirmed that nurses had a positive attitude toward the APS, mainly because they believed it offered patients significant advantages. Man y of them thought that epidural analgesia and PCA were likely to imped e patient's ambulation and most of them agreed that these techniques i ncreased their work load. Conclusion: Although the incidence of respir atory depression was low among the APS patients, it can probably still be decreased by a more refined patient selection. Setting up an APS i s viewed positively by the nursing staff in spite of some perceived di sadvantages.