We commend the article from Drs. Applegate and Buckenmaier in the November 2013 ASA NEWSLETTER. The Department of Defense and Veterans Health Administration efforts toward reliable and accurate postoperative adult pain assessment are praiseworthy. The Defense and Veterans Pain Rating Scale (DVPRS) appropriately incorporates aspects of emotional function (sleep, mood, stress) into its questionnaire, in addition to a subjective pain intensity score.
Several key considerations merit discussion. The first is distinguishing acute from chronic pain; the second, nociceptive from neuropathic pain; and the third, malignant from non-malignant pain management. It is useful to emphasize these distinctions because the duration of pain and the response to analgesic strategies may vary. The remainder of our discussion refers to adult, acute postoperative pain management.
Ideally, postoperative acute pain assessments should include static (rest) and dynamic (sitting, coughing or moving the affected part) pain. Static measures may relate to the patient’s ability to...
