Episode 253: The Acute Pain Service with Drs. Segna, Rayaz, Jaremko and Barnhart

Acute pain management in hospitalized patients requires a systematic, multimodal approach that prioritizes patient safety and functional recovery over the singular goal of eliminating pain. Effective strategies involve combining non-opioid analgesics—such as acetaminophen, NSAIDs, and gabapentinoids—with regional anesthesia and targeted IV infusions like ketamine or lidocaine to minimize opioid requirements and associated side effects. Clinicians must perform thorough chart reviews, including prescription drug monitoring and assessment of renal or hepatic function, to tailor regimens to individual patient needs. Because opioids carry risks of respiratory depression and ileus, they should be administered on an as-needed basis rather than on a fixed schedule. Ultimately, successful pain control hinges on clear communication with patients regarding realistic expectations, active monitoring for toxicities, and the integration of behavioral coping mechanisms to support early mobilization and prevent complications like pneumonia.