Department of Surgery, Department of Anaesthesia, Faculty of Medicine, Université de Sherbrooke, Clinical Pain Research Laboratories of the Research Centre of the Sherbrooke University Hospital, Sherbrooke, Quebec, Canada
open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution-Non-Commercial 4.0 International Public License (CC BY-NC 4.0) (https://creativecommons.org/licenses/by-nc/4.0/legalcode), which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.
* Address correspondence to this author at the Department of Surgery, Department of Anesthesia, Faculty of Medicine, Université de Sherbrooke Research Center of the Sherbrooke University Hospital, Sherbrooke, Quebec, Canada; Tel: 1 819 574-1229; E-mail: Serge.Marchand@USherbrooke.ca
Chronic Pain Management for the Hospitalized Patient
The primary reason for patients to visit hospital is pain. They don't necessarily know the reason of the pain however, they can precisely describe when the pain started, it’s evolution, location and intensity. The motivation to be free of this painful condition is clear. In fact, it is generally the importance of the painful condition that will alert the patient that there is a need to consult. In most cases, the doctor will find the health problem responsible for this painful condition, and with the adequate treatment, the pain will gradually disappear in parallel with the healing process. Pain is therefore actually a blessing in several conditions. Without this signal, health problems that can be cured if diagnosed rapidly enough can become a serious threat without adequate treatment. Pain is also an important tool for clinicians, giving important information on the clinical condition, the evolution and the effect of treatment. Clinicians in a hospital environment are prepared to intervene on acute pain conditions; they have the necessary skills and equipment to deal with them.
Chronic pain is a very different condition that can be present even without any clear pathophysiological sign. In this case, it is no longer a blessing but rather a curse for most patients suffering for no apparent reason. It is generally not seen as an emergency and or life threatening. It is therefore generally perceived as a problem that should be cared for by a family doctor or pain clinic specialists. For these reasons, the importance of chronic pain management in hospitals has too often been a neglected topic.
In their book Drs. Rosenquist, Souzdalnitsky and Urman have brilliantly addressed this problem and have clearly explained the importance of chronic pain management for the hospitalized patient. They invited several very competent clinicians to write chapters on different topics of chronic pain treatment adapted to the hospital environment. They give personalized information for all hospital services including the emergency department, intensive care, labour and delivery units, palliative care and psychiatric units. Specific problems in paediatric and geriatric care are described. They also emphasize the importance of a collaborative work between all health disciplines including nurses, pharmacists, psychologists and rehabilitation specialists. They address specific issues such as addiction, spinal cord stimulators and intrathecal pumps that will come with some patients suffering from chronic pain. Finally, an emphasis is made on preventing postoperative chronic pain, a very important problem that is still not sufficiently known by the medical community.
It is an excellent reference book addressing multiple aspects that should be known by all clinicians to give the most effective chronic pain management in a hospital environment. It’s a must-have for professionals working in a hospital who want a good reference book for the treatment of chronic pain.