Are your surgical pts also treated for pain during the procedure?

[kukukajoo, LPN]

We had a discussion in class regarding whether to medicate for pain in a comatose pt which then led to do you medicate a pt in surgery. I have read studies that show that have proven that they can still "feel pain" while under anesthesia... Our class was certainly split on this but nobody knew if it is standard practice or even widespread.

We never really got to the bottom of this and it left me wondering about this.

Thanks!

[TazziRN, RN]

I know that in this area anything done with spinal anesth. also gets Duramorph instilled.

[meandragonbrett]

Yes, typically patients will receive narcotics during surgery. Generally fentanyl is used (of course, dependent on individual anesthesia provider).

[wtbcrna, MSN, DNP, CRNA]

Yes, surgical patients receive pain meds/anesthesia during surgery. It doesn't necessarily mean that it is given as IV meds. It can be done through high doses of anesthetic gases, spinal/epidural, regional techniques, and/or local anesthetic infiltration. Usually it is combination of more than one technique ie. IV meds, anesthetic gases, and local anesthetic.

Another big thing that we are taught right now in nurse anesthesia school is pre-emptive analgesia...where we actually premedicate with pain meds in order to block a pain response before your body has a chance to physiologically respond.

[Spidey's mom, ADN, BSN, RN]

As others have stated, it is standard practice to medicate for pain during surgical procedures.

steph

[kukukajoo, LPN]

That is EXACTLY what I thought and was totally shot down in class like I was an idiot! Even the one who swears he is going to be a CRNA and had just shadowed one disagreed! I have read their books as I am interested in this as a future possibility and from the looks of combos used, there is pain management as well as sleepy time meds....

I just let it go though as I figured I must be wrong if so many think otherwise.

The original discussion was on a closed TBI placed in medical coma pt scenario and the prof asked if we would treat for pain and I said aboslutely and stated several studies that show it is beneficial and that the body still responds, etc. Would help keep the cranial pressure down...The future CRNA said absolutely not, he would never treat a TBI pt in a coma for pain......

I did some more reading today and sure enough, you treat for pain.

[GilaRRT]

I think we are talking about different concepts. On one hand you have a TBI patient, on the other hand you are talking about somebody having a MAC. When we talk about pain, we are talking about a very complex physiological and psychological experience.

Even under properly performed general anesthesia, your body can still react to pain. This does not equate to experiencing pain on a "conscious level"; however, one could argue the body "feels pain" while under anesthesia.

As far as, TBI treatment modalities. I have never placed a patient in a barb coma, so I cannot give any intelligent answers regqarding the proper methods to use for this form of treatment. I have had to fly many TBI patients who were intubated, and I typically give very liberal doses of narcotics to these patients.