Abstract Insufficiencies in education, fear of side effects and the lack of standards and organisational background are major barriers preventing improvements in acute pain therapy. In view of this, guidelines have been set up and implemented into clinical practice during the last few years in many countries, and acute pain services have been established. Following the activities in Great Britain and the United States, national guidelines for Germany have been set up in 1997, edited by the national societies of anaesthesiologists and surgeons. These ‘Guidelines for the Management of Acute Perioperative and Post-traumatic Pain’ include instructions and algorithms on patient information, diagnostic features and measurement of pain using pain scores, systemic analgesia with opioids, NSAIDs and co-analgesics. They also provide guidelines for the use and monitoring of different application modes such as enteral, intravenous, subcutaneous and patient controlled administration. Furthermore, chapters provide guidelines on regional analgesia (including epidural and intrathecal application of opioids and/or local anaesthetics), preemptive analgesia, prophylaxis and treatment of side effects (‘symptom control’) of analgesics. Special issues are acute pain management in children, outpatients and drug addicts; quality assurance in acute pain therapy is emphasised. Major topics include guidelines for organising acute pain therapy (eg how to run an acute pain service), and for cooperation, agreements and responsibilities of anaesthesiologists, surgeons and nurses for acute pain management on general surgical wards. A survey on postoperative pain management in surgical departments in Germany was performed before release of the guidelines. Further evaluations will show whether the implementation of these guidelines resulted in significant improvements in clinical practice.
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Open Access
Mar 1, 1998
J Pouttu 
