Mary Jane recieved only pro re nata (PRN) medication. She experienced high levels of post op pain and her recovery was delayed. As a consequence she encountered post operative complications. She went to rehab but after some time her pain had not resolved. She now had chronic pain and had to be re admitted for further surgery.
Hi Mary I am the physician, I am sorry to hear you have been experiencing high levels of pain, we will review your analgesia and arrange regular doses rather than pro re nata. I am sorry to tell you that you have developed a DVT so we'll adjust your medication for that.
Preparing local anesthetic and reversing the general anesthetic once you're done Jim.
I have completed the procedure, prepare me some local anesthetic for wound closure Donald.
I have no pain at this time only a 1/10 at the surgical site
How is your pain Mary on a scale of 0-10?
How is your pain now Mary on a scale of 0-10? My pain is so sever it is 10/10!!
oh dear. . . I had better go and prepare some intramuscular Morphine
It has been three months since my total knee Arthroplasty and I still have so much pain and I can't walk without this frame.
Acute pain can progress to chronic pain if the pain response is not adequately suppressed. Mary had to go back to surgery for a manipulation of her knee replacement.
Donald I think this time we should use a preemtive, multi-modal approach to ensure we can manage Mary's pain post operative. Yes Jim I agree, I will also review her tomorrow once she is back on the ward.