IPRO's study found that pre-operative discussions between medical staff and patients discussing the various options available for pain management were found in only 13 percent of the cases examined. Less than half the patients studied benefitted from existing pain assessment tools used to gauge degree of discomfort. It is clearly within our means to manage pain and discomfort after surgery, yet hospitals are not taking full advantage of proven pain management techniques. Hospital personnel offered non-pharmacologic techniques of pain control in only 11 percent of the cases. Federal guidelines cite the value of certain behavioral interventions such as relaxation therapies for selected patients.
Meperidine can produce side effects including dysphoria, confusion and hallucinations.
One key to improved performance lies in better education of both medical staff and patients. Expanded patient education is also needed. Patients should ask their doctor and nurse what to expect, examine pain control options, and work with medical personnel to devise a suitable pain control plan. The IPRO study analyzed 220 Medicare charts selected at random representing patients who were discharged in New York State between October 1994 and September 1995 with the diagnosis of total knee replacement or total or partial hip replacement. These cases were then assessed for compliance with federal health policy guidelines.