SAFETY ASSESSMENT OF POSTOPERATIVE PAIN MANAGEMENT BY AN ACUTE PAIN SERVICE

While there are increasing demands for improved post-operative analges ia and the implementation of Acute Pain Services (APS), the safety of such an approach remains under discussion. This paper analyses the saf ety outcome of 3016 consecutive post-operative patients treated under the care of a formalised Acute Pain Service. No serious complication r esulting in morbidity or mortality occurred. Potentially severe compli cations without sequelae were discovered in 16 patients (0.53%); this incidence was similar for techniques of systemic opioid administration and continuous regional analgesia. Patient-controlled analgesia (PCA) alone had a significantly lower rate of respiratory depression than P CA with a background infusion or continuous morphine infusion. In 1069 patients receiving continuous regional analgesia (epidural, interpleu ral, peripheral) no trauma to nervous structures, no infection and no local anaesthetic toxicity occurred. In conclusion, an anaesthesiology -based APS can provide postoperative pain relief using a wide range of relatively invasive techniques without endangering patient safety.