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Acute pain management

Updated: Apr 6, 2021

General understanding statements:

Seperation between acute pain and a chronic pain is an arbitrary one

Better to think of it as 'acute pain is consequence of injury - and chronic pain is persistent pain once the initial insult has healed'

Acute pain is generally useful - allows us to note the cause and move away from harm. However, it can be maladaptive - such as increased insomnia due to hypervigilence when experiencing pain - preventing appropriate sleep and recuperation.

Risk factors for chronic pain from acute pain:


Chronic pain before the operation, psychological vulnerabilities (including catastrophisation), female gender, younger age.


Poorly controlled acute post-operative pain

Preventative factors for developing post-acute chronic pain:

Regional anaesthesia techniques, peri-operative pregabalin and gabapentin possibly.

Assessment of acute pain:

Need to consider both active and inactive levels of pain

Can use a Functional Activity Scale (A: No limitation, B: Mild limitation, C: Significant limitation)

Essential reading:

Schug SA, Palmer GM, Scott DA, Halliwell R, Trinca J. 2015. Acute pain management: scientific evidence (4th ed.). Melbourne: Faculty of Pain Medicine.

Schug SA, Scott DA, Mott JF, Halliwell R, Palmer GM, Alcock M; APM:SE Working Group of the Australian and New Zealand College of Anaesthetists and Faculty of Pain Medicine.

​Macintyre PE, Loadsman JA, Scott DA. 2011. ‘Opioids, ventilation and acute pain management’. Anaesthesia and intensive care 39 (4): 545–58. EZ

Macintyre PE, Schug SA. 2015. Acute pain management: a practical guide (4th ed.). Boca Raton: CRC Press. NA

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