Acute Pain: Resident Educational Objectives

Knowledge

• Anatomy and physiology of pain transmission, pain fibers, and pathways.
• Pharmacology of opioids, local anesthetics, narcotic antagonists, and adjuvants to pain management including nonsteroidal antiinflammatories, antiemetics. laxatives, and antipruritics.
• Treatment of post-operative patients in pain with intravenous and epidural analgesia.
• Treatment of side effects such as pruritus, nausea, vomiting, constipation, sedation, and respiratory depression.
• Appropriate use and dose of narcotic and local anesthetic concentrations for specific surgical operative sites and for thoracic versus lumbar epidurals.
• Treatment of chronic pain patients in acute pain, either surgical or medical.
  

Skills

• Be able to convert parenteral to oral pain medications.
• Be able to troubleshoot problems with BARD PCA pumps.
  

Performance

Be able to respond and evaluate

1. Patients with hypotension
2. Patients with an epidural catheter who have a fever
3. Patients with a leaking epidural catheter
4. Patients who have their epidural disconnected from the pump
5. Patients with epidural analgesia who have new sensory or motor changes (from regional anesthesia complications - either from the anesthetic or a hematoma versus operative positioning complication)
6. Patients who either need a bolus of their analgesia or a change to another analgesia

Duramorph