In 1996, the campaign to help prevent under assessment and poor management of pain
popularized the slogan, “pain as the 5th vital sign.” [
[1]
] The basis of the campaign was to make healthcare workers place the same importance
on pain assessment as the existing 4 vital signs. The campaign led to widespread adoption
within the medical field [
[2]
]. As a result, the United States Hospital Consumer Assessment of Healthcare Providers
and Systems survey included the question “How often did the hospital or provider do
everything in their power to control your pain?” [
[3]
] This formally established a connection between the treatment of pain and the United
States Hospital Consumer Assessment of Healthcare Providers and Systems survey used
to facilitate reimbursement by the Centers for Medicare and Medicaid Services. The
unintended consequence of the emphasis on pain assessment and treatment and reimbursement
to healthcare systems may have contributed to the opioid epidemic in the United States
[
[2]
]. As a result, many medical specialties and regulatory bodies have withdrawn their
support of the “pain as the 5th vital sign” campaign [
[2]
].To read this article in full you will need to make a payment
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References
- Quality improvement guidelines for the treatment of acute pain and cancer pain. American Pain Society Quality of Care Committee.JAMA. 1995; 274: 1874-1880https://doi.org/10.1001/jama.1995.03530230060032
- “Pain as the fifth vital sign” and dependence on the “numerical pain scale” is being abandoned in the US: why?.Br J Anaesth. 2018; 120: 435-438https://doi.org/10.1016/j.bja.2017.11.098
- Are pain management questions in patient satisfaction surveys driving the opioid epidemic?.Am J Public Health. 2016; 106: 985-986https://doi.org/10.2105/AJPH.2016.303228
- Updates on multimodal analgesia for orthopedic surgery.Anesthesiol Clin. 2018; 36: 361-373https://doi.org/10.1016/j.anclin.2018.05.001
- Anesthesia and analgesia practices in total joint arthroplasty: a survey of the American Association of Hip and Knee Surgeons membership.J Arthroplasty. 2019; 34: 2872-2877.e2872https://doi.org/10.1016/j.arth.2019.06.055
- Tranexamic acid use in total joint arthroplasty: the clinical practice guidelines endorsed by the American Association of Hip and Knee Surgeons, American Society of Regional Anesthesia and Pain Medicine, American Academy of Orthopaedic Surgeons, Hip Society, and Knee Society.J Arthroplasty. 2018; 33: 3065-3069https://doi.org/10.1016/j.arth.2018.08.002
- AAHKS Anesthesia & Analgesia Clinical Practice Guideline Workgroup, Hamilton WG, Della Valle CJ. Acetaminophen in Total Joint Arthroplasty: The Clinical Practice Guidelines of the American Association of Hip and Knee Surgeons, American Society of Regional Anesthesia and Pain Medicine, American Academy of Orthopaedic Surgeons, Hip Society, and Knee Society.J Arthroplasty. 2020; 35: 2697-2699
- AAHKS Anesthesia & Analgesia Clinical Practice Guideline Workgroup, Buvanendran A, Hamilton WG, Della Valle CJ. Gabapentinoids in Total Joint Arthroplasty: The Clinical Practice Guidelines of the American Association of Hip and Knee Surgeons, American Society of Regional Anesthesia and Pain Medicine, American Academy of Orthopaedic Surgeons, Hip Society, and Knee Society.J Arthroplasty. 2020; 35: 2700-2703
- AAHKS Anesthesia & Analgesia Clinical Practice Guideline Workgroup, Hamilton WG, Della Valle CJ. Nonsteroidal Antiinflammatory Drugs in Total Joint Arthroplasty: The Clinical Practice Guidelines of the American Association of Hip and Knee Surgeons, American Society of Regional Anesthesia and Pain Medicine, American Academy of Orthopaedic Surgeons, Hip Society, and Knee Society.J Arthroplasty. 2020; 35: 2704-2708
- AAHKS Anesthesia & Analgesia Clinical Practice Guideline Workgroup. Opioids in Total Joint Arthroplasty: The Clinical Practice Guidelines of the American Association of Hip and Knee Surgeons, American Society of Regional Anesthesia and Pain Medicine, American Academy of Orthopaedic Surgeons, Hip Society, and Knee Society.J Arthroplasty. 2020; 35: 2709-2714
- The Efficacy and Safety of Acetaminophen in Total Joint Arthroplasty: Systematic Review and Direct Meta-Analysis.J Arthroplasty. 2020; 35: 2715-2729
- The Efficacy and Safety of Gabapentinoids in Total Joint Arthroplasty: Systematic Review and Direct Meta-Analysis.J Arthroplasty. 2020; 35: 2730-2738
- The Efficacy and Safety of Nonsterioidal Anti-Inflammatory Drugs in Total Joint Arthroplasty: Systematic Review and Direct Meta-Analysis.J Arthroplasty. 2020; 35: 2739-2758
- The Efficacy and Safety of Opioids in Total Joint Arthroplasty: Systematic Review and Direct Meta-Analysis.J Arthroplasty. 2020; 35: 2759-2771
Article info
Publication history
Published online: May 22, 2020
Footnotes
One or more of the authors of this paper have disclosed potential or pertinent conflicts of interest, which may include receipt of payment, either direct or indirect, institutional support, or association with an entity in the biomedical field which may be perceived to have potential conflict of interest with this work. For full disclosure statements refer to https://doi.org/10.1016/j.arth.2020.05.036.
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© 2020 Elsevier Inc. All rights reserved.
