//
archives

Pain

This category contains 4 posts

The Toyota approach to anaesthesia- small continuous improvements: using placebo, IV cannulation, echo, blocks and compression devices

Toyota is famous for improving their cars through a process of continuous, small, incremental improvements, a technique known as Kaizen, or the Toyota way. In this way many small improvements, each inconsequential on their own, when added together produce significant results. I think this is a great model to use when looking at anaesthesia. Anaesthesia … Continue reading

Agitation and Pain in the Recovery Room (tutorial)

Problem: A 43 year old male returns from the operating room following cholecystectomy. The operation had been originally planned using the laparoscopic approach. However it became necessary to convert to an open procedure. Intraoperatively the patient received fentanyl 300mic/g, propofol, vecuronium, oxygen and desflurane and cefazolin. At the end of surgery, neuromuscular blockade (sustained tetanus … Continue reading

Perioperative Single Dose Ketorolac to Prevent Postoperative Pain

Anesth Analg. 2012 Feb;114(2):424-33 I have been a sceptic of meta-analyses, for many years. The purpose of these studies is to take a large volume of literature; both published and unpublished, and test hypotheses. The idea is to replicate a large randomized controlled trial by combining many studies together.¬† Unfortunately, rather than coming up with … Continue reading

ASA Periopeative Pain Guidelines

The ASA has issued guidelines for acute pain management in the perioperative setting. Click on this link to read guidelines.¬†Obviously there is a North American flavour to these guidelines, but they are generalisable. Summary: 1. Institutional Policies and Procedures for Providing Perioperative Pain Management Anaesthetists offering perioperative analgesia services should provide ongoing education and training … Continue reading