Anaesthesiology (Pain Management & Critical Care)

Pain management and critical care are medical specialties focusing on patient care involving the diagnosis, treatment, and care of chronic pain in critically ill patients. The terms “pain management” and “critical care” are two distinctive specialties, each dedicated to their own specific aspects of patient care. How do these specialties differ and what do they each cover?

Pain management, as the name dictates, focuses on helping you understand, manage, and treat pain, may it be acute pain (sudden pain due to injury or trauma that will lessen and heal over time) or chronic pain (persistent pain for a long time, beyond the expected healing period that may be continuous or “on” and “off”, typically lasts longer than 3 months). Such pain may come from an injury, surgery, medical conditions and diseases, nerve damage, etc. Pain is a symptom of a variety of medical conditions such as cancer, arthritis, autoimmune disorders, endometriosis, migraines, and many more. It is recommended for you to always visit your doctor with the feeling of unexpected pain as it may quickly lead to serious outcomes.

When visiting your doctor, your type of pain is evaluated to determine the root cause, which may be categorized as acute pain, chronic pain, nociceptive and neuropathic pain. Typically, in an appointment, the area and severity of pain is discussed. Further diagnostic tests may occur, if necessary, such as blood test, x-rays, imaging tests such as computed tomography (CT) scan and magnetic resonance imaging (MRI). Doctors in this field, also known as pain management specialists or anaesthesiologists, are specially trained to help you regulate your pain through personalized treatment plans for your conditions to improve function, quality of life, and overall well-being of your body.

List of procedures:
  1. Injections and stimulations
    1. Trigger point injections/steroid injections for pain relief directly to specific area
    2. Spinal cord stimulation, transcutaneous electrical nerve stimulation (TENS) or radiofrequency ablation to relieve nerve pain
  2. Medications/Drug therapy
    1. Nonprescription/over-the-counter (OTC) medications such as acetaminophen, NSAIDs (nonsteroidal anti-inflammatory drugs such as aspirin and ibuprofen) that help relieve muscle aches and reduce inflammation/swelling
    2. Topical pain relievers
  3. Counselling and therapy
    1. E.g., Cognitive behavioural therapy, biofeedback, meditation and relaxation techniques providing psychological treatment
  4. Exercise
    1. Such as Pilates, yoga and tai chi may help reduce chronic pain and improve overall body function besides maintaining positive mental health
  5. Hands-on treatments
    1. E.g., physical therapy, massage, acupuncture, chiropractic treatment, osteopathic (bone) manipulative therapy (OMT), therapeutic touch & reiki healing
  6. Lifestyle changes

On the other hand, critical care focuses on the close monitoring and advanced medical treatment of patients with life-threatening illnesses or injuries, typically in a hospital setting within the intensive care unit (ICU). The critical care team consists of critical care-trained physicians, anaesthetists, intensivists, pharmacists, nutritionists, critical care nurses, respiratory therapists, and physical and occupational therapists to provide you with personalized care and treatment plans catered to your situation. You may fall into critical care due to sudden attack of critical illness or after a surgery such as: 

  1. Post-cardiac surgical care and cardiac failure
  2. Post-neurosurgical critical care and brain injuries
  3. Severe infectious diseases and sepsis
  4. Respiratory failure requiring ventilation and weaning
  5. Acute liver and kidney disease
  6. Long-term recovery from critical illnesses
  7. Severe third-degree burns
  8. Shock 
  9. Heart failure
  10. Stroke
List of Treatment Plans:

Our critical care team provides you with personalised care and treatment plans catered to your individual situation including: 

  1. Use of advanced life support measures (e.g., mechanical ventilation, respiratory therapy and tracheostomy for breathing assistance)
  2. Multi-organ support for vital organs such as liver, kidneys, lungs and blood through extracorporeal membrane oxygenation (ECMO)
  3. Hemodynamic monitoring
  4. Anaesthesia and pain management
  5. Physical rehabilitation treatment such as physiotherapy
  6. Dialysis and renal services
  7. Intravenous (IV) medicines and fluids through IV tubes for medication and nutritional support

Both pain management and critical care specialties play crucial roles in improving patient outcomes, enhancing quality of life, and providing compassionate care for patients with complex medical needs. A multidisciplinary approach through collaboration with other specialists including physicians, nurses, psychologists, physical therapists, occupational and vocational therapists and nutritionists and dietitians, ensures comprehensive and coordinated care for critically ill patients in managing their illness and recovery.

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