PAIN MANAGEMENT DEVELOPMENT IN RSWS-FKUH “NOT JUST TO GIVE EXCELLENT PAIN SERVICE BUT TO BE A CENTRE FOR PAIN EDUCATION

3. PAIN MANAGEMENT DEVELOPMENT IN
MAKASSAR
Department of Anesthesiology, Intensive Care and Pain Management
Faculty of Medicine, Hasanuddin University

4. PAIN SERVICES IN RSWS HOSPITAL
As a part of Anesthesiology, Intensive Care and
Pain Management Department
 ACUTE PAIN SERVICE ( APS )
 CHRONIC PAIN SERVICE ( Pain Clinic )
 CANCER PAIN SERVICE

5. PELAYANAN NYERI AKUT (APS)
Tujuan APS RSWS
 Memberikan Analgesia pasca bedah
 Aplikasi dan pengembangan teknik analgesia
yang baru
 Pelatihan bagi dokter dan perawat dalam
penanganan nyeri
 Sebagai lahan penelitian dan pengembangan
keilmuan

6. ACUTE PAIN SERVICE FKUH-RSWS MAKASSAR
( 2004 – JUNE 2009)
 Provide management analgesia postoperative
 Mainly, EPIDURAL ANALGESIA
 Regular assessment and record
 Resident based APS Anesthesiologist Supervised
 Panduan Pelayanan Nyeri Pasca Bedah FKUH-RSWS
 About 2832 patient from april 2004 – dec 2009

7. APS PATIENT RECORD

8. RECORDING IN WARD AND HCU

9. F, 32 yr. Haemorrhoidectomy , 5 days after
SC, with cont epidural analgesia
Male, 70 y.o. Fracture Femur, with
continuous epidural analgesia
Male, 52 y.o. Post laparatomy, with
Patient Controlled Epidural Analgesia Anesthesiologist-supervised APS

10. DIAGRAM KASUS SESUAI PEMBEDAHAN
N=2823,2004-2009
0.00
10.00
20.00
30.00
40.00
30.77 29.53
13.40
22.08
2.48 0.74 0.99
%
%

11. DIAGRAM KASUS APS SESUAI PEMBEDAHAN
TAHUN 2010, N=812
0
20
40
60
80
100
120
140
160
Intermittent
Continuous

12. DIAGRAM INTENSITAS NYERI ( NRS ) N=2823,2004-
2009
15.88
81.39
2.73 0.000.00
10.00
20.00
30.00
40.00
50.00
60.00
70.00
80.00
90.00
0 1 - 3 4 - 6 7 - 10
Persentase tingkat nyeri
Persentase tingkat nyeri

13. DIAGRAM TINGKAT KEPUASAN N=2823,2004-
2009
persentasi tingkat…0.00
10.00
20.00
30.00
40.00
50.00
60.00
70.00
80.00
0.00
5.96
79.40
14.62 persentasi tingkat
kepuasaan

14. WHAT THE PATIENT GET FROM OUR APS ?
16%
81%
3% 0%
Persentasetingkatnyeri
0
1 - 3
4 - 6
7 - 10

15. WHAT THE APS DOCTOR GET ?
0.00
5.96
79.40
14.62
0.00 20.00 40.00 60.00 80.00 100.00
tidak puas
kurang puas
puas
sangat puas
%
%
INNER SATISFACTION OF THE DOCTOR ………
TINGKAT KEPUASAN PASIEN

16.  Opening of KLINIK NYERI DAN AKUPUNTUR RSWS-
FKUH
 NOVEMBER, 2006

17. Eastern – Western combined
1. Acupuncture with Needle stimulation, Heater Lamp,
Cupping
2. Trigger Point Injection
3. Epidural Steroid Injection
4. SGB ( Stellate Ganglion Block )
5. Nerve Blocks
( Intercostal, Suprascapularis, etc )
CLINIC MODALITIES

18. CLINIC RESOURCE
 HUMAN RESOURCES
 TRAINING OVERSEAS (
US, JAPAN, CHINA, THAILAND, SINGAPORE )
 WORKSHOP OVERSEAS
( US, CANADA, HONGKONG, THAILAND )
 FACILITY
 5 BEDS CLINIC
 CHINESE TCM ( e.g. Electro-accupuncture, heat lamp
etc )
 ULTRASOUND Guide Nerve Block and Trigger point
injection
 RADIOFREQUENCY

19. PAIN CLINIC SITUATION

20. REKAP PASIEN PAIN CLINIC ( 2010-2011)
0
50
100
150
200
250
300
semester
awal 2010
semester
akhir 2010
semester
awal 2011
78
190
287

21. JUMLAH KUNJUNGAN PASIEN DI PAIN KLINIK THN
2010-2011
0
50
100
150
200
250

22. PAIN DIAGNOSED IN PAIN CLINIC
 Miofascial pain
 Back Pain, radicular and non-radicular
 Shoulder Pain
 Postherpetic Neuralgia
 Trigeminal Neuralgia
 Arthritis
 Headache
 etc

23. PROCEDURES IN PAIN CLINIC

24. INTERVENTION PROCEDURES IN COT

25. TO BE A CENTRE OF PAIN TRAINING ,
EDUCATION AND DEVELOPMENT
 Nurse education
 Medical Student Clerkship
 Accupunture and TCM Course
 Pain Education for GP doctor
 Pain Update Meeting
 Intervention Pain Management Workshop

26. NURSE TRAINING FOR PAIN MANAGEMENT
“ make pain visible “

27. MEDICAL AND STUDENT EDUCATION ON PAIN

28. ACCUPUNTURE AND TCM COURSE
 Start from 2006, every year, with 2 professor/doctor
from Xiamen University
 20-30 Participants each course

29. INTERVENTION PM WORKSHOP
 Intervention pain workshop with Singapore
instructure ( 2006 )
 Intervention Pain Management workshop with
manniquine under c-arm fluoroscopy
(Since 2010; every 6 month; 15-20 paticipants each
workshop)

30. CONCLUSION
 PAIN MANAGEMENT DEVELOPMENT IN RSWS-FKUH
“NOT JUST TO GIVE EXCELLENT PAIN SERVICE
BUT TO BE A CENTRE FOR PAIN EDUCATION “

31. Terima kasih