Pain management in the trauma setting

Abstract

One critical aspect of trauma management is dealing with pain. It is, nowadays, well understood that appropriate treatment of pain in injured patients would improve care results. Injured patients are often experiencing considerable pain while being clinically unstable. Such instability makes these patients susceptible to analgesic interventions. Morbidity and mortality are high among trauma patients due to various effects on their vital systems. Trauma complications, such as hypovolemia, coagulopathies, and head or spine injuries, are frequently encountered and would limit several pain relief approaches. In the recent decades, there have been significant advances in posttraumatic pain management. This added to the increased awareness of the consequences of undertreating posttraumatic pain, has produced adaptation of therapeutic concepts, such as multimodal and multidisciplinary approaches to pain in injured patients. The following text serves as a concise discussion of the management of pain in the trauma setting. We outlined posttraumatic pain concept, pathophysiology, clinical presentation, clinical approach and treatment. Towards the end of the text, we devoted special headlines to discuss some specific scenarios that might require a particular management.