PS41(G) Acute pain
18 September 2023
We've released the final updated version of professional document PS41(G) Position statement on acute pain management and accompanying background paper (PS41(G)BP).
A group of eminent pain medicine and anaesthesia experts undertook a review of PS41(G) Acute pain encompassing all forms of acute pain utilising best available evidence to guide practice by all doctors managing acute pain.
Given the significant advances since the last review, the process was lengthy and involved, necessitating multiple meetings, email exchanges, stakeholder consultations, and a six-month pilot period. A significant addition is the appendix on analgesic stewardship with its comprehensive insights into the entire spectrum of factors contributing to high quality management of acute pain.
The contentious issue of routine prescription of modified release (MR) opioids required consideration to ensure consistency with available evidence and with other standard setting bodies. The recommendation to avoid routine prescription of MR opioids is because these preparations are designed to prolong the action of the medications making their titration challenging in comparison with immediate release (IR) formulations, and consequently, less effective. They have also been associated with increased risk of opioid induced ventilatory inhibition (OIVI) and persistent post-discharge opioid use (PPOU). The recommendation to avoid routine prescription of MR opioids in the absence of demonstrable benefit, monitoring, and cessation plan aligns with the analgesic stewardship standards of the Australian Commission on Safety and Quality in Health Care Opioid released in 2022.
Please see the final updated version of ANZCA and FPM professional document PS41(G) Position statement on acute pain management (PS41(G) Acute pain) and accompanying background paper (PS41(G)BP).
Thank you to the Document Development Group:
- Professor Pam Macintyre, Lead
- Dr Michael Foss
- Wing Commander (Dr) Kylie Hall
- Dr Kim Hattingh
- Dr Michael Lumsden-Steele
- Dr Peter Roessler
- Clinical Associate Professor Joanna Sutherland
- Dr Peter Waterhouse
Thank you to the Expert Group:
- Dr Mark Alcock
- Dr Poranee Buttery
- Associate Professor Victoria Eley
- Dr Phillipa Hore