Clinical response assessment should start before initiating drug therapy because each patient is different in ability to tolerate pain and in interpretation of pain. In planning clinical response assessment, the patient might be asked prior to initiating drug therapy about his or her current level of pain and what level he or she would like to achieve. The answers may be surprising because patients might prefer not to have total pain elimination, but rather have the pain reduced to a tolerable level. The patient is the person best able to define the desired level of comfort between unacceptable side effects and total pain relief.
The clinician should attempt to achieve the patient's desired level of pain relief and minimize untoward side effects. Achieving this balance may be much harder than just simply eliminating the pain. Clinical assessment should have a baseline reference for comparison, preferably the baseline before surgery in terms of cognition and level of consciousness. Assessment for sedation and altered mental status is necessary in assessing a patient's clinical response to analgesic pharmacotherapy. Along with clinical response assessment, the patient's level of sedation and oxygenation should be assessed whenever aggressive drug therapy is indicated.
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