Development of acute pain service in an Indian cancer hospital.

Postoperative pain relief continues to be a major challenge for all health care professionals caring for such patients in India. Acute pain services are almost nonexistent, even in large private and university hospitals. As per our estimate not more than 10 such services are available. Tata Memorial Hospital is a tertiary care cancer center that started one of the first Acute Pain Services (APS) in India in 2002 to provide safe and effective postoperative pain management. APS guidelines and protocols have since been implemented and patients are monitored by a team of a consultant physician, a nurse, and a medical resident. Audits are done at regular intervals to evaluate the efficacy of service and patient satisfaction. Pain scores declined yet the patient satisfaction has not improved. Postoperative outcome studies are yet to be undertaken. The development and current activities of the APS that can be implemented in a country that does not have sophisticated acute pain management teams are described.