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Uncontrolled Acute Postoperative Pain
Case Synopsis
A 35-year-old woman is scheduled for a partial colectomy due to complications from her ulcerative colitis. She has a history of migraine headaches, endometriosis, fibromyalgia, and nonspecific low back pain. She is currently on a high-dose oral opioid regimen. She is nervous, having catastrophizing thoughts about not surviving, and having chronic and difficult-to-treat pain after her surgery.
Problem Analysis
Definition
Pain is defined by the International Association for the Study of Pain (IASP) as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage. Pain is always subjective; each individual learns the application of the word through experiences related to injury in early life.”
Postoperative pain can be divided into one of two broad categories: acute postoperative pain and chronic postoperative pain. Acute pain is defined as “pain of recent onset and probable limited duration. It usually has an identifiable temporal and causal relationship to injury or disease” and is typically expected to last up to 7 days. In contrast, chronic pain “commonly persists beyond the time of healing of an injury and frequently there may not be any clear identifiable cause” ( ) and persists for more than 3 months.
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