Perioperative pain management: a gate control perspective.
The assessment and management of perioperative pain are critical skills for the surgical nurse, hence, the subjective nature of pain should be reflected in their approach to pain control. Unfortunately, many studies (Seers 1987, Kuhns et al 1990, Royal College of Surgeons and Royal College of Anaesthetists 1990, Closs 1992 and Field 1996) suggest that the nurse's knowledge of perioperative management is inadequate. However, as Carr (1997) reported, nurses are not the only group of health care professionals who demonstrate a lack of 'expertise' in providing analgesic relief. Carr reviewed the survey of 27 medical schools by Marcer and Deighton in 1988 which revealed that 4 schools undertook no formal teaching on pain control, and the remainder averaged only 3.5 hours during a four year course. Clearly, perioperative pain management remains a major problem! We have suggested that surgical nurses must have a sound knowledge of the neurophysiology associated with this subjective phenomenon (Clancy and McVicar 1998) since such an understanding is paramount in assisting the decision making process which underpins effective individualised perioperative pain management.
Clancy
J
J
Surgical and Theatre Nursing, University of East Anglia.
McVicar
A
A
D000700:Analgesics / Q000627:therapeutic use*; D004509:Education, Nursing, Continuing; D006801:Humans; D010149:Postoperative Pain / Q000188:drug therapy* / Q000503:physiopathology; D019990:Perioperative Care / Q000379:methods*; D013527:Perioperative Nursing / Q000379:methods
D000700:Analgesics