Comparison of WHO Pain Ladder Management versus Severity-based Pain Management in Patients Presented with Acute Abdominal Pain Visiting Emergency Department

Abstract Aimand Objectives: The present study was undertaken to evaluate whether patients that are administered analgesics depending on their initial pain severity are more satisfied with their treatment than those who are given analgesics in accordance with the WHO pain ladder management protocol. Materials and Methods: First consecutive 100 patients (Group I) with abdominal pain were treated with WHO pain ladder management and for the next 100 patients (Group II), the pain management was done based on their intensity of pain. All patients were assessed for relief of pain every 15 min based on visual analog scale (VAS). Results: The visual analog pain score started decreasing after the administration of analgesics in both groups. The VAS was monitored once every 15 min for 60 min and in each measurement, the score was slightly lower in Group II in comparison to Group I ( P > 0.05). At the end of 60 min, the mean score was <4 in both groups. Eighty-six percentage of the patients in Group II and 79% of the patients in Group I were satisfied with their pain relief. Although the satisfaction level of patients was higher in Group II, it was not found to be statistically significant ( P = 0.282). Conclusion: The usage of analgesics for pain management can be decided based on the severity of the pain instead of following the pain ladder management proposed by WHO. This can prevent the unnecessary usage of analgesics such as paracetamol and certain side effects due to that.