Managing acute postoperative pain: Is 3 hours too long?

Philip Ang, Hazel Knight, Christina Matadial, Ana Pagan, Rosemarie Curty, Carmen S. Nieves, Ana A. Acevedo, Francisca P. Dalisay

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


This case study discusses a 64-year-old opioid-tolerant patient who underwent amputation below the left knee and received pain management in the PACU. The patient's self-reported pain level remained 9 on a 0 to 10 scale despite having received a total of 62 mg of morphine sulfate (MSO 4) and 60 mg of ketorolac in just less than 3 hours. The patient's facial expression corresponded to a score of 4 to 5 based on the Wong-Baker Faces Pain Scale. This case study illustrates that it is crucial to promptly involve the pain management service when an opioid-tolerant patient requires aggressive pain treatment. The initial patient-controlled analgesia (PCA) order and MSO 4-loading doses must take into account the patient history of opioid tolerance, increasing the frequency and dosage-loading doses of MSO 4 for treating severe pain until the patient's pain is reduced by at least 50% on a numeric scale, or until the patient states satisfactory relief. The most important rule of pain management is that pain is what the patient says it is.

Original languageEnglish (US)
Pages (from-to)312-333
Number of pages22
JournalJournal of Perianesthesia Nursing
Issue number5
StatePublished - Oct 2004
Externally publishedYes

ASJC Scopus subject areas

  • Medical–Surgical


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