RESULTS OF PAIN TREATMENT IN MILITARY MEDICAL CLINICAL CENTERS FOR COMBATANTS AFTER GUNSHOT WOUNDS

Abstract

Resume. Unfortunately, the treatment of combatants with gunshot wounds does not end with wound healing. In 66.7 %-73.1 % of these patients, pain becomes chronic and affects quality of life. Therefore, studying the results of pain treatment in combatants after gunshot wounds in military medical clinical centers can help identify weaknesses on the way to improving the results of treatment of this category of patients. Objective. To study the results of treatment of combatants' pain after gunshot wounds in military medical clinical centres. Methods. The data on the results of treatment of 769 combatants with gunshot wounds after combat operations are presented. The intensity of pain during treatment was monitored using a visual analogue scale (VAS). Also, the time interval between analgesia was recorded. The groups were compared by the Mann-Whitney test and the chi-square test, taking into account the correction for continuity. To test the distribution of quantitative indicators for normality, the Shapiro-Wilk test was used, and to analyse the dynamics of indicators, the Friedman test for related samples was used, and a posteriori comparison was performed using the Bonferroni correction. Results. On admission, the VAS pain intensity in the 2 groups was practically the same and met the criteria of moderate and severe pain, here the number of points ranged from 4 to 7, which indicates the lack of quality pain control and low effectiveness of analgesia in the preliminary stages or during medical evacuation. on the 14th day after injury, the VAS pain intensity practically corresponded to 2 points – mild pain, which indicates stable pain control and sufficiently high-quality pain treatment. However, on the 9th day of observation (p=0.009, and then <0.001), there was a difference, which is most likely due to the number of injured anatomical areas of the patient. The intervals between anesthetizations gradually increased. However, from the 10th day of observation there is a difference between the groups (p<0.001). Conclusion: The data obtained indicate that at the stage of treatment in military mobile hospitals, from which combatants are evacuated to military medical clinical centres, as well as during evacuation, more attention should be paid to the issue of pain management, because the lack of quality pain control between treatment stages is one of the factors that affects the frequency of pain chronicity.