VAS instrument is used with all age groups and is the approved pain scale for use at

Shands Hospital at the University of Florida.

 Analgesic medication use. Medications dispensed during a patient's hospitalization

are records in the Medication Administration Record (MARS). The MARS documents

each dose of medicine administered by nursing personnel. This medication record

contains the medication name, date, time, dosage and initials of hospital personnel

administering the medication. Individual Medication Administration Records (MARS)

were evaluated for the use of narcotic analgesic medication for every participant. An

Opioid equi-analgesic conversion table was used and all opiates were standardized to

morphine sulfate equivalents. For example, 1.5 mg IV Hydromorphone = 100 mcg

IV/SC Fentanyl = 20 mg P.O. Oxycodone = 10 mg IV Morphine (Pasero, Portenoy &

McCaffery, 1999). Total IV Morphine Sulfate equi-analgesic conversion was recorded

for each postoperative day for three days.

 Regional anesthesia use. Regional anesthesia techniques such as epidural, Femoral

Nerve Sheath Catheters, and Psoais Compartment Catheters provide postoperative pain

relief by blocking nerve conduction with local anesthetics, thereby blocking the

transmission of pain (Pasero, Portenoy, & McCaffery, 1999). The use of a local

anesthestic provides a sensory and motor blockage. The epidural regional anesthesia

technique occasionally requires the use of an opioid agent in addition to a blocking agent.

The use of an opioid agent is recorded on a separate analgesic document in the patient's

medical record. The placement location of regional anesthesia is recorded on a separate

document located within the patient's medical record.