Pain assessments - gabapentin?????

[martymoose]

Now we are being told we have to reassess pain within an hour for gabapentin. When did this happen?? Gabapentin is for chronic nerve problems , like numbness and tingling. I should know- I am on it myself.If I am having pain ( like from my torn meniscus) neurontin does absolutely nothing for that pain. It just stops the burning sensation from my neuropathy. Knee still hurts!I have heard similar situations from other patients.

This is not a prn med like tylenol or narcs for post surgery.I don't get why this is being included in the pain reassessment.It will probably always show as a "pain not relieved score"

Does this mean we should reassess for lyrica, all antidepressants incl. cymbalta, anti seizure meds, muscle relaxers, etc?

This is out of hand.

[Gabby-RN]

Where I work, gabapentin administration also generates a pain assessment field and 1 hour re-assessment. So does 81mg of aspirin and Tylenol given for fever. We have been told if the medicine is not given for pain to put "0" in the pain scale field and then comment in the comment box "given for fever" or "ACS protocol". Many people are just skipping the pain assessment all together which is making the hospitals scores go down and making it look like we don't address pain.

[morte, LPN, LVN]

they need to get the program rewritten...

Where I work, gabapentin administration also generates a pain assessment field and 1 hour re-assessment. So does 81mg of aspirin and Tylenol given for fever. We have been told if the medicine is not given for pain to put "0" in the pain scale field and then comment in the comment box "given for fever" or "ACS protocol". Many people are just skipping the pain assessment all together which is making the hospitals scores go down and making it look like we don't address pain.

[Interpolfan89]

I can see just doing it as part of an overall pain assessment but Gabapentin's ability to control pain depends on a certain level of the medication being present over time. It is not prescribed as a prn med. So if there pain is not relieved they may need to increase the dosage if the pateint is not already on their maximum and is taking it as prescribed. Sure it may be a good drug but I thinks its odd that they are making you check for relief after a dose considering the nature of the drug.

Actually it is prescribed as both a scheduled and prn med. Idk about it being more effective than opioids since it has to be given in such a high dose to compare. It would be nice if we didn't have to reassess it though since it would be one less thing to do.

[Tenebrae, BSN, RN]

I can't like your post enough. Doing a pain score for neurontin is ridiculous and lets not give them any ideas about the other meds cymbalta, lyrica, etc! They want us to ask the patient's their pain score every time we see them. If they have chronic pain I don't think every time I'm in the room asking them their pain level is going to help them, it will only remind them of their pain, esp if it's too soon for their pain meds.

Not only that by asking them about their pain all the time its inadvertantly reminding them of it and making distraction techniques somewhat useless

[CardiacKittyRN]

We reassess it too :/ along with a few other things such as Solumedrol given IVP. It wants us to reasses after an hour with the "time infusion ended". All pointless to me..

[Salter444]

Even though there are pain relieving implications for gabapentin I cannot see the rationale for checking pain an hour following a dose. It is not controlled and it is not like you will have a pen dose if ineffective. No bueno!

[NurseMellie]

In my facility, we have been using gabapentin more often for certain types of pain. We monitor the pain level at administration but not necessarily an hour after its given. Really when you think about it, we are assessing our residents all the time without even realizing it. So you may know if it has worked or not. Now are you required to document the after effectiveness on all pain medication?

[martymoose, BSN, RN]

In my facility, we have been using gabapentin more often for certain types of pain. We monitor the pain level at administration but not necessarily an hour after its given. Really when you think about it, we are assessing our residents all the time without even realizing it. So you may know if it has worked or not. Now are you required to document the after effectiveness on all pain medication?

Yes. they are to rate their pain 1-10, and are asked if they are satisfied with that.This must be documented.

[NurseMellie]

Bah! It was probably someone who doesn't get the concept of how meds work in the body