PART 1:
HPI: A 78-year-old man who is TO UNDERGO a left above the knee amputation due to a limb abscess
PMH:
Peripheral artery disease for 18 years
Cardiomyopathy
BPH for 13 years
FH: Mother had osteoporosis; father had diabetes
SH: Lives with wife; has two grown children
MEDS:
Aspirin 81mg daily
multivitamin 1 daily
pantoprazole (Protonix) (PPI) 40 mg daily
tamsulosin (Flomax) 0.4 mg daily
atorvastatin 80 mg at bedtime
PAIN ASSESSMENT: Patient rates pain as 8 on a scale of 0 to 10
1. Based on the type of injury, what type of pain is this patient likely to experience?
Based on the patient having a surgical amputation, he would have acute pain that would be severe initially. Further, I would expect him to experience nociceptive pain as a result of the surgical injuries to bone and soft tissues, as well as neuropathic pain as a result of the “changes in peripheral axon properties and neuronal circuitry in both the peripheral and central nervous systems” (Kuffler, 2018). “This [amputation] leads to a complicated, mixed, form of pain and a highly varied array of different postoperative pain syndromes” (Neil, 2016).
2. What type of pain management regimen would you suggest in the postoperative period? Explain your answer.