Ugeskrift for laeger
-
Realizing that achievement in postoperative pain treatment was not satisfactory, central health authorities in USA, United Kingdom and Australia have published guidelines for managing acute pain. Establishing acute pain services is thought to be one of the means of improving pain relief in the individual patient. ⋯ At this moment, introduction of acute pain services is at a preliminary stage in Denmark, and consequently an overview of results obtained from abroad is given including pain treatment techniques, management and safety measures, as well as visions concerning the impact of optimal pain relief upon convalescence. We conclude that the introduction of acute pain services is bound to optimize postoperative patient care and might well prove to be a significant factor in reducing postoperative morbidity.
-
Late postoperative hypoxaemia is a common phenomenon, and is probably an important pathogenetic factor in the development of cardiac, cerebral and wound complications after major surgery. Thus, oxygen therapy may play an important role in the postoperative care of the surgical patient. Diagnosis of hypoxaemia is most cheaply and easily performed with pulse oximetry. ⋯ Further studies of pathogenesis, treatment and clinical implications of late postoperative hypoxaemia are therefore warranted. It is our opinion, until further data is available, that monitoring of oxygenation is indicated in all patients after major surgery, and that hypoxaemia should indicate supplementary oxygen therapy. Proposed guidelines for monitoring and oxygen therapy are provided.