Abstract
Pain management has remained a challenge for surgeons since the dawn of organised medicine. A massive influx of unproven techniques and alternative therapies has descended upon us with little regard to true efficacy and even safety. It is incumbent upon us as practitioners of medicine to finally begin to pay more attention to the tenets of evidenced based medicine while making therapeutic choices.
Johns Hopkins has had a long history of dealing with pain in many of its chameleon forms ranging from the management of acute post-operative pain to the more difficult management of chronic pain. To effectively manage pain in a surgical practice requires attention to first establishing the type of pain (ie. nociceptive or neuropathic). Once the type of pain is clear, specific algorithms can be worked out based on the principles of evidenced based medicine which can be carried out by a variety of paramedical personnel (ie. Physician Assistants or Nurses) without specific surgeon input. This maximises benefit to the patient and minimises problems for the surgeon. Specific algorithms for the management of acute LBP, chronic LBP, acute postoperative pain, chronic postoperative pain, cancer pain and sociopathic pain will be discussed.
The abstracts were prepared by Dr Robert J. Moore. Correspondence should be addressed to him at The Spine Society of Australia, Institute of Medical and Veterinary Science, The Adelaide Centre for Spinal Research, Frome Road, Adelaide, South Australia 5000
