Evaluation of continuous nerve block for postoperative pain management in orthopaedic surgery

Objective. - After orthopaedic surgery, continuous nerve block analgesia provides effective postoperative pain relief. The practical use of these techniques may present problems. The purpose of this study was to assess the development of continuous block procedure for postoperative pain based on quality standard management and the effectiveness of initial training as an adjunct for introduction of these techniques. Materials and methods. - A staff committee of anaesthesiologists established a specific pratical working protocol. The medical and paramedical teaching sessions were immediately evaluated using a questionnaire. Results. - 214 consecutive patients were included. The incidence of side effects and complications were higher in the beginning of protocol. Constant improvement of these results was observed throughout the study. The rate patients with pain were 10%. The analysis of medical evaluation should permit to determine an acceptable level of quality. Most patients were satisfied with their management. Conclusion. - Pain management quality assurance program provided an improvement in efficacy of postoperative pain management in our protocol. Further, evaluation may be required to assess the complete benefits of this new protocol as regards postoperative pain. (c) 2005 Elsevier SAS. Tous droits reserves.