ANZCA Final Exam Resources
Day 1

Pain

Know the summaries in the acute handbook
Know the position statement on acute pain management (PS41)
Use functional assessment of pain
Anxiety/mood should not be treated with opioids
Opioids put patients at risk of OIVI - asses risk
Assess risk of persistent post-discharge opioid use
Analgesia should be evidence based
Use multimodal analgesia
Consider opioid stewardship
How can pain be measured?
Sensory (how do you feel)
Affective (what is your mood)
Cognitive (underlying factors that impact the experience of pain)
Functional activity scale
A: no limitation (able to undertake activity without pain)
B: mild limitation (able to undertake activity with moderate-severe pain)
C: unable to undertake activity due to pain
Chronic postsurgical pain (CPSP)
Pain developing or increasing in intensity after a surgical procedure, in the area of the surgery, persisting beyond the healing process
Hot topic
MASTER study
Published in Lancet in 2002
RCT of thoracic epidural vs PCA for open abdominal/thoracic surgery in high-risk patients
Outcomes
Less pain with epidural over first 72 hours
Less respiratory failure
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