INTERDISCIPLINARY POSTOPERATIVE PAIN THER APY AT A UROLOGIC CLINIC - OUR EXPERIENCE

From 1992 to 1996, postoperative pain management for patients undergoi ng major urologic surgical procedures has been performed on an interdi sciplinary basis by Acute Pain Service of the Clinic of Anaesthesiolog y the and the Clinic of Urology. The Acute Pain Service consists of tw o members of the medical staff and two nurses. Since the introduction of the service, the majority of 1920 patients have received patient-co ntrolled analgesia (PCA) via intravenous pump with piritramid or conti nuous peridural analgesia. Acceptance of standardised pain management by patients, nursing staff, physicians and physiotherapists has been h igh. More than 90% of the patients have rated the therapy as highly sa tisfactory and would request this method of analgesia in the future. I nterdisciplinary cooperation is carried out on a consultation basis, a lthough the Acute Pain Service assumes responsibility for the administ ration of analgesics, antiemetics and sedatives after discussion with the consultant and for predetermined periods of time. The nursing staf f is responsible for providing pain therapy, i.e. for the availability and preparation of the respective medication as well as for monitorin g pain therapy. As the nursing staff is informed about the respective monitoring requirements and threshold values, it is able to inform a p hysician of the Acute Pain Service of the presence of values above or below the normal range for the individual monitoring parameters. This allows an intensive exchange of information and an ongoing professiona l discussion among physicians from both specialities, as well as const ant feedback from the nursing staff and physiotherapists, resulting in a transparency which provides the basis for sound interdisciplinary c ooperation.