Patient Assessment and Pre-operative

Assessment of pain is the essential prerequisite for successful pain management. First step in pain assessment is to ask the patient about the pain intensity and believe them. Lack of a diagnosis should not preclude administration of adequate analgesia while a diagnosis is sought. 

Acute and chronic pain is often separated by the artificial time limit of 3 months. In reality, they are part of a continuum. Chronic pain is better defined as pain from continuing disease or pain that continues beyond the time expected for normal healing. Acute pain is usually short lived and of known origin.

In most situations, the simple model of 'assessment, treatment, reassessment' in combination with diagnosis and treatment of the underlying condition will resolve the problem. The most common multidimensional pain scales are the McGill Pain Questionnaire, and the Brief Pain Inventory, but many others are available. 

Fear of prescribing to opioid abusers often leads to inadequately treated pain. However, the nature of the lifestyle of abusers means that they are more likely to suffer chronic painful conditions than the general population.

Preanaesthetic check up is ideally done few days prior to surgery in a PAC and usually a day prior to surgery. A system-based enquiry is generally used to identify the disease processes that may influence anesthesia. Most hospitals provide a pre-assessment questionnaire for patients to fill in before the anesthetist’s visit. A Patient's stomach must be empty to reduce any risk of aspiration-ward staff must be aware to keep the patient nil by mouth (no food or drink).