Background
Acute pain management is one of the main concerns of the anesthesiologist, particularly in the post-operative period.
Other forms of acute pain include sudden pain due to burns or trauma, sudden illness, or chronic pain agudization.
Healthcare professionals’ lack of training and fear of opioid side effects can lead to undertreated acute pain.
Acute Pain Units (APU) leaded by anesthesiologists experienced in pain treatment can have a broad field of action, supporting other clinicians in non-surgical acute pain management in different hospital settings.
Objective
To evaluate the APU’s contribution to non-surgical pain treatment in HDESPD from 2011 to August 2017.
Methods
Retrospective study using an internal database.
Results
The APU followed 11788 patients, 71 for non-surgical pain - 49 (69%) males and  22 (31%) females. The average age was 63.4 years (min. - 15, max. - 91).
The referring specialties were General Surgery (36,6%), Vascular Surgery (36,6%), ICU (15,6%), Urology (5,6%), Orthopedics (4,2%) e Gastroenterology (1,4%)
67,6% of patients were ward inpatients, 25,3% were ICU patients and 7,1% were in the emergency room.
The most frequent referral causes were rib fractures (35,2%), lower limb ischemia (33,8%) and acute pancreatitis (14,1%).
The most frequent analgesia type was epidural (74,7%) and conventional analgesia (21,1%), and 1 case of cervical plexus block (1,4%), morphine PCA (1,4%) and a conventional + epidural analgeisa(1,4%).
24% of cases had 3 or less observations by the APU, 31% 4 to 6 observations and 45% over 6 observations.
Complications: Epidural catheter exteriorization (n=3), subarachnoid epidural catheter migration (n=1) and deaths (n=3) unrelated to analgesia .
Conclusion
Pain management is currently a priority widespread through medical specialties. 
The APUs’ knowledge and pain management experience can have a broader reach in the hospital setting.

10 / Acute Pain Unit management of non-surgical acute pain - a seven-year audit