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Correspondence  |   January 1995
How Many Acute Pain Services Are There in the United States, and Who Is Managing Patient-controlled Analgesia?
Author Notes
  • Professor, Department of Anesthesiology RN-10, Director, Acute Pain Service, University of Washington Medical Center, University of Washington School of Medicine, Seattle, Washington 98195.
Article Information
Correspondence
Correspondence   |   January 1995
How Many Acute Pain Services Are There in the United States, and Who Is Managing Patient-controlled Analgesia?
Anesthesiology 1 1995, Vol.82, 322. doi:
Anesthesiology 1 1995, Vol.82, 322. doi:
To the Editor:—Anesthesiology-based acute pain services were described in 1988. [1,2 ] Although many have appeared subsequently both in academic and private practice settings, there is little information regarding the current number of acute pain services in the United States.
Patient-controlled analgesia (PCA) is an important modality that has been used widely by anesthesiologists to manage acute pain, but recent economic and political factors have prompted some anesthesiologists to stop providing PCA or to relegate this method of care to others. There is no published information characterizing current PCA management patterns in the United States.
A survey was undertaken in April 1994 to examine these two issues. The survey started with a list of the 2.254 hospitals in the country with 100 beds or more. After stratifying these institutions geographically to ensure country-wide representation, a sample of 500 was randomly selected. A questionnaire was mailed to the directors of anesthesiology departments at each institution. It contained the following questions:
1. Is there an anesthesiology-based acute pain service in your hospital?
2. Is PCA used in your hospital?
3. What group(s) of physicians manage PCA: anesthesiologists, surgeons, oncologists, other (specify)?
4. What is the ZIP code of your hospital?
Responses were received from 324 (65%) of the institutions surveyed. Table 1and Table 2show the information obtained.
Table 1. Participating Institutions
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Table 1. Participating Institutions
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Table 2. Therapist Groups Managing Patients Who Receive Patient-controlled Analgesia
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Table 2. Therapist Groups Managing Patients Who Receive Patient-controlled Analgesia
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The proportion of respondents (73%) indicating the existence of an anesthesiology-based acute pain service was surprisingly large. Because all institutions were randomly selected and their responses were anonymous, it is not known what proportion of these were academic centers and what proportion came from private practice. Because the term “anesthesiology-based acute pain service” was intentionally not defined, it is likely that the time and resources applied to acute pain management vary widely among respondents.
PCA is now used, at least to some extent, in almost all American hospitals with 100 or more beds. Anesthesiologists are still the largest single group managing PCA, although there are substantial numbers of other therapists.
L. Brian Ready, M.D., F.R.C.P.(C.), Professor, Department of Anesthesiology RN-10, Director, Acute Pain Service, University of Washington Medical Center, University of Washington School of Medicine, Seattle, Washington 98195.
(Accepted for publication October 20, 1994.)
REFERENCES
Ready LB, Oden R, Chadwick HS, Benedetti C, Caplan RA, Wild LM: Development of an anesthesiology-based postoperative pain management service. Anesthesiology 68:100-106, 1988.
Saidman LJ: The anesthesiologist outside the operating room: A new and exciting opportunity (editorial). Anesthesiology 68:1-2, 1988.
Table 1. Participating Institutions
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Table 1. Participating Institutions
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Table 2. Therapist Groups Managing Patients Who Receive Patient-controlled Analgesia
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Table 2. Therapist Groups Managing Patients Who Receive Patient-controlled Analgesia
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