Acute pain services (APS), as a go-getter acronym!

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Sir, The recent issue of your esteemed journal addresses an important component of perioperative care, in the form of a research article on acute pain services (APS) by Agarwal et al.,[1] which happens to be pretty much the need of the hour. We congratulate the authors and thank them for sharing their institutional APS experiences with us. Although the notion of APS dates to 1980s, it has reformed to evolve into the present concept of “transitional pain services” wherein pain management begins from the preoperative period and continues until postdischarge.[2] While the authors highlight the benefits of establishing an APS team;[1] they ought to have simultaneously elaborated on the concurrent role of other members featuring in an ideal APS team including surgeon, physiotherapist, psychiatrist, psychologist, pharmacist, and trained nursing staff.[3] Acknowledging the importance of the former for a holistic pain management; it remains unclear as to why the authors’ team was limited to the inclusion of nurse and anesthesiologists.[1,3] Herein, an insight into the model of APS adapted in their setup could have helped in better understanding of the structural organization of the team.[3] Even having read through the complications observed by the authors during their routine follow-up of postoperative patients, it is believed that a brief discussion on the action strategies put in place by the respective team to manage or ameliorate these complications would have benefited the readers.[1] Speaking of audits in specific, they undoubtedly feature in the list of the essential roles and responsibilities of an APS team. However, as highlighted, audits involving an interdisciplinary team can be more productive in bringing up the shortcomings in the existing system, thus playing a crucial role in developing or refining the existing protocols for improved patient outcomes.[3] APS, at the heart of the matter, is a patient-centric service wherein they are educated regarding all the aspects of pain management right from the preoperative phase to instate decision-making power in them.[4] The idea of shared decision-making revolves around active patient involvement in their pain management, particularly when faced with modern-day challenges such as opioid tolerance or chronic opioid use.[4] To ascertain patient involvement various approaches have been developed, such as: “MAking Good decisions In Collaboration” (MAGIC); “Benefits, Risks, Alternatives, and doing Nothing” (BRAN); “Seek, Help, Assess, Reach and Evaluate” (SHARE); “the Multifocal APProach to sharing IN Shared-Decision Making” (MAPPIN’SDM), etc.[5] To conclude, looking at the intricacies of APS; we wish to propose an acronym, as a befitting representative of its’ very working fundamentals [illustrated in Figure 1].Figure 1: An acronym for acute pain services, relevant to the present-day contextFinancial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.

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