• F M Bardiau, M M Braeckman, L Seidel, A Albert, and J G Boogaerts.
• Department of Anesthesiology, University Hospital Center, Charleroi, Belgium.
• J Clin Anesth. 1999 Nov 1;11(7):583-9.

Study ObjectivesTo assess the effects of an Acute Pain Service (APS) inception on postoperative pain management in a general teaching hospital using pain indicators as performance measures.DesignOpen, prospective, nonrandomized, observational study.SettingPostanesthesia Care Unit, surgical wards of University Hospital Center of Charleroi.Patients1304 patients in the pre-APS inception phase and 671 patients after its implemention who have undergone various types of surgery (orthopedics, gynecology, urology, neurosurgery, stomatology, ear, nose, and throat, ophthalmic, abdominal, vascular-thoracic, plastic, and maxillofacial).InterventionsAn APS, nurse-based, anesthesiologist-supervised model was devised, based on the concept that postoperative pain relief can be greatly improved by providing in-service training for surgical nursing staff and optimal use of systemic analgesics.Measurements And Main ResultsPostoperative pain was assessed using a visual analog scale (VAS) every 4 hours for 72 hours in the two phases. Analgesic consumption was registered at the same time. Time-related VAS scores were summarized using several pain indicators. There was an overall improvement in the pain scores after APS inception. The differences were most pronounced, around 50%, in patients undergoing vascular, maxillofacial, gynecologic, and urologic surgeries, and stomatology. Regular administration of paracetamol and nonsteroidal antiinflammatory drugs decreased morphine consumption in the second phase.ConclusionThis study validates the benefits of a formal APS, using continuous monitoring of rest pain intensity and analgesic consumption in the postoperative period. Results not only support previous research findings but also offer outcome-based tools to evaluate current practices as compared with desired outcomes.

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