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Acute pain management services have progressed, albeit insufficiently in Canadian academic hospitals

[Les services de traitement de la douleur aiguë ont évolué, mais pas suffisamment, dans les hôpitaux universitaires canadiens]

From the Department of Anesthesiology, Kingston General Hospital, Queen’s University, Kingston, Ontario, Canada.

Address correspondence to: Dr. David H. Goldstein, Department of Anesthesiology, Kingston General Hospital, 76 Stuart St., Kingston Ontario K7L 2V7, Canada. Phone: 613-549-6666, ext. 3399; Fax: 613-548-1375; E-mail: goldsted{at}kgh.kari.net

Purpose: Acute pain management services (APMS) evolved in response to the desire for improved management of postoperative pain. The management of postoperative pain received formal support from international organizations over the past decade and by 1993 half of the Canadian university-affiliated teaching hospitals had implemented an APMS. The purpose of this survey was to describe APMSs in Canadian academic institutions, with specific emphasis on postoperative analgesics, new analgesic methods, training and research.

Methods: Between June 2000 and January 2001, 62 Canadian hospitals affiliated with the 16 Canadian university anesthesiology departments were sent a postal questionnaire.

Results: Fifty of the 62 respondents returned a completed questionnaire representing a response rate of 81%. Eighty percent of the hospitals surveyed had at least 200 beds, 90% (45) had implemented an APMS. Anesthesiology was primarily responsible in all 45 hospitals with an APMS. The results presented are based on the 45 centres with an APMS.

Conclusion: Since the early 1990s the percent of Canadian academic hospitals with an APMS has increased from 53% to 92%. These figures are comparable to the United States. Greater collaboration from nursing and pharmacy, mandatory training for medical and nursing students and residents, and a standardized approach to continuous quality improvement remain necessary.

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