Acute Pain Management: Current Best Evidence Provides Guide for Improved Practice: Table 1

Abstract

Effective management of acute pain is a major priority for both patients and healthcare providers. Inadequate control of acute and postoperative pain can lead to adverse outcomes that include pulmonary and thromboembolic complications and additional time in hospital or intensive care, with associated increased costs [1]. It can also have negative effects on mobility and function, emotional well-being, quality of life, and overall recovery [2]. Although significant advances have been made in the understanding, assessment, and management of acute pain, further improvements in clinical practice are required. This can be assisted by the provision of up-to-date evidence-based guidelines. The Australian and New Zealand College of Anaesthetists (ANZCA) and Faculty of Pain Medicine (FPM) have recently published the Second Edition of “Acute Pain Management: Scientific Evidence”[3]. This document is a compilation of current evidence and expert practice relevant to acute pain management across a wide range of patient populations and clinical settings, and therefore a systematic approach with multidisciplinary collaboration was required. A Working Party was convened by ANZCA to appoint contributors and edit submissions. Searches of electronic databases and recent publications were conducted (as outlined in Appendix B of the document) and were greatly aided by systematic reviews that had been published by the Cochrane Collaboration and Oxford Pain Group. Evidence was graded according to current Australian National Health and Medical Research Council (NHMRC) criteria (see Table 1) with assistance from the NHMRC Guidelines Assessment Register. Since the publication of the First Edition, “expert opinion” is no longer graded as evidence. However, as high levels of evidence are not available for all interventions, recommended best practice based on experience and expert opinion was included as “clinical practice points.” The initial draft document was reviewed by a multidisciplinary consultative committee, made up of members of …