Acute Pain Management: A Practical Guide, Fourth Edition, 4th Edition (Hardback) book cover

Acute Pain Management

A Practical Guide, Fourth Edition, 4th Edition

By Pamela E. Macintyre, Stephan A. Schug

CRC Press

287 pages | 26 B/W Illus.

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Hardback: 9781482233490
pub: 2014-12-04
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Highly Commended, BMA Medical Book Awards 2015

Comprehensive acute pain management no longer means only caring for patients with pain resulting from postoperative and trauma-related causes—it now includes managing patients with acute pain arising from a wide variety of conditions.

Acute Pain Management: A Practical Guide provides health professionals with simple and practical information to help them manage patients with acute pain safely and effectively. The book also helps them to identify and manage acute pain in more complex patients, for whom effective treatment can be challenging.

In this new edition, chapters have been revised and updated, often extensively, to reflect current knowledge and practice. This resource will undoubtedly be helpful to a variety of professionals in assessing and managing acute pain.


"This is the fourth edition of a practical guide to acute pain management, and the first edition that includes access to an ebook version. … This is a handy resource for anyone who takes care of patients in pain, regardless of the setting. The authors are experienced clinicians who have been writing about this subject for a long time. … There are others books on acute pain management, but they tend to focus more on theory than on practice. This one provides the nitty-gritty details of pain management that are expected to be taught at the bedside but often are not."

—Tariq M. Malik, MD, University of Chicago Pritzker School of Medicine in Doody's Book Reviews

"This exceptional book incorporates a conglomerate of evidence about acute pain. Outstanding is the concise format which makes it very usable for clinicians."

—Prof. Esther Pogatzki-Zahn, MD, Department of Anesthesiology, University Hospital Muenster, Germany

Table of Contents


Effectiveness of Acute Pain Management

Adverse Effects of Undertreated Severe Acute Pain

Acute Pain Management and Patient Outcomes

Delivery of Effective Acute Pain Management


Guidelines and Protocols

Acute Pain Services

Assessment and Monitoring

Types of Pain

Assessment of Pain and Pain Relief

Assessment of Adverse Effects

Pharmacology of Opioids

Mechanism of Action

Effects of Opioids

Predictors of Opioid Dose

Titration of Opioid Dose

Commonly Used Opioid Agonists


Opioid Antagonists

Pharmacology of Local Anesthetics

Mechanism of Action

Efficacy of Local Anesthetics

Adverse Effects of Local Anesthetics and Their Management

Commonly Used Local Anesthetic Drugs

Nonopioid and Adjuvant Analgesic Agents


Nonselective Nonsteroidal Antiinflammatory Drugs

COX-2 Selective Inhibitors (coxibs)

Alpha-2-adrenergic Agonist Drugs

Antidepressant Drugs

Anticonvulsant Drugs

Membrane Stabilizing Drugs

Inhalational Agents



Systemic Routes of Opioid Administration


Subcutaneous and Intramuscular





Patient-Controlled Analgesia


Analgesic Drugs Used with PCA

The PCA "Prescription"

Requirements for the Safe Management of PCA

Management of Inadequate Analgesia

Complications of PCA

"Step-down" Analgesia

Alternative Systemic Routes of PCA Administration

Epidural and Intrathecal Analgesia



Drugs Used with Epidural Analgesia

Requirements for the Safe Management of Epidural Analgesia

Patient-Controlled Epidural Analgesia

Management of Inadequate Analgesia

"Step-down" Analgesia

Complications and side Effects of Epidural Analgesia

Concurrent Antithrombotic or Antiplatelet Therapy

Intrathecal Analgesia

Other Regional and Local Analgesia

Continuous Peripheral Nerve Blockade

Intraarticular Analgesia

Wound Infiltration

Topical Analgesia

Nonpharmacological Therapies

Psychological Interventions

Transcutaneous Electrical Nerve Stimulation


Physical Interventions

Acute Neuropathic and Persistent Postacute Pain

Pathophysiology of Neuropathic Pain

Clinical Features and Diagnosis of Neuropathic Pain

Acute Neuropathic Pain Syndromes

Treatment of Acute Neuropathic Pain

Progression of Acute to Persistent Pain

Preventive Analgesia

Nonsurgical Acute Pain

Burns Injury

Spinal Cord Injury

Other Specific Conditions

More Complex Patients

Older Patients

Opioid-Tolerant Patients

Patients with an Addiction Disorder

Patients with Obstructive Sleep Apnea

Pregnant or Lactating Patients

Patients with Renal or Hepatic Impairment

Opioid Analgesia after Discharge from Hospital

Potential Risks

Choice of Discharge Opioid Regimen

Information for Patients and Treating Doctors

Self-Assessment Questions



About the Authors

Pamela E. Macintyre, BMedSc, MBBS, MHA, FANZCA, FFPMANZCA, Director Acute Pain Service, Department of Anaesthesia, Pain Medicine and Hyperbaric Medicine, Royal Adelaide Hospital and clinical associate professor, Discipline of Acute Care Medicine, School of Medicine, University of Adelaide, Australia.

Stephan A. Schug, MD, FANZCA, FFPMANZCA, Professor and Chair of Anaesthesiology, Pharmacology, Pharmacy and Anaesthesiology Unit, School of Medicine and Pharmacology, University of Western Australia and Director of Pain Medicine, Royal Perth Hospital, Australia.

Subject Categories

BISAC Subject Codes/Headings:
HEALTH & FITNESS / Pain Management
MEDICAL / General
MEDICAL / Neurology