In July 2010 SPIN hosted the visit of two Ukrainian anaesthetists, Dr Ivan Lisnyy and Dr Yuriy Novosad to London. The aim was to share information about how to set up and run an acute pain service (APS) and to observe the safe and effective techniques commonly used in the UK for acute post-operative pain management. The planned outcome was to establish the first APS in Ukraine at the National Cancer Institute in Kiev.

On his return to Kiev, Dr Lisnyy set up an APS at this hospital. The first few months were spent educating a team of nurses and doctors in acute pain management and establishing APS protocols. The first patients were treated in April 2011 since when an average of fifty patients a month have received epidurals for post-operative pain relief following major surgery.

happy patient

pain scale
The photographs show a young man 24 hours following major abdominal surgery and his response to the question ‘do you have any pain?’ together with a pain scoring ruler (with permission).

It is extremely difficult to obtain effective injectable or oral pain-relieving drugs for patients in Ukraine. Before the introduction of this APS service, the vast majority of patients would have suffered severe pain following their operations. Epidural analgesia is hugely effective and the drugs used are cheap anaesthetic agents which are readily available in Ukraine.

Dr Lisnyy has now established his own teaching programme in Kiev and has trained 120 doctors and nurses from all over Ukraine in acute post-operative pain management. A second APS has now been established at another hospital in Kiev. The total cost of the educational visit to London for the two doctors was just over £2000. Here is a quote from Dr Lisnyy following his visit to the UK.

“Since I came back to Ukraine, I held a lecture about medical training in London and some new experiences. We discuss improving our work by:
- improving aseptic and antiseptic in hospital – more information for patient and staff
- improving our acute pain team documentation (using your samples)
- more attention to staff training and examining in pain problems
- start use of intravenous infusion of fentanyl for postoperative pain management
- start use of lidocaine infusion for chronic cancer pain management
- start use paravertebral block for analgesia during and after mastectomies
- continue our work for creating protocols of pain assessment and management.”

Brigitta Brandner and Lesley Bromley are shown below attending the first chapter meeting of the Ukranian IASP chapter with some of the Ukranian visitors. At the meeting, the work supported by SPIN was presented and the Ukranian team were highly complimented by Professor Henrik Kehlet (Copenhagen, far left). Professor Kehlet is a world authority in recovery from surgery.

Kehlet et al