The changing face of acute pain services

Area of Science:

• Pain Management
• Hospital Medicine
• Clinical Outcomes

Background:

• Acute Pain Services (APS) were initially designed for postoperative pain management.
• This study examines current challenges and the evolving role of APS in an academic hospital.
• The research assesses APS impact on surgical and medical pain intensity and patient characteristics.

Purpose of the Study:

• To prospectively review challenges faced by APS teams.
• To assess the effects of APS on surgical and medical pain intensity.
• To define patient characteristics and risk factors influencing frequent APS visits.

Main Methods:

• Prospective cohort study at Uppsala University Hospital over one year.
• Enrolled patients referred to APS, collecting demographic, medical history, and pain data.
• Analyzed pain scores pre- and post-treatment, number of follow-ups, and used logistic regression for frequent visit predictors.

Main Results:

• 730 patients (58% surgical, 41% medical) showed a 25-30% reduction in pain intensity.
• Median Numerical Rating Scale (NRS) scores significantly decreased for severe and moderate pain.
• Frequent APS follow-ups were associated with chronic neuropathic/nociceptive pain, mental diseases, opioid dependency, and female gender.

Conclusions:

• APS effectively reduces pain intensity, but its focus has shifted beyond acute surgical pain.
• Current APS challenges include managing hospitalized patients with high comorbidity of psychiatric diseases, opioid dependency, and chronic pain.
• The interdisciplinary APS team requires expansion to include psychiatry, psychology, and rehabilitation specialists for complex pain states.