Preliminary Study of Pre-hospital Pain Management and Comparison of Pain Management Methods in Emergency Patients
Abstract
Background: Pain is an unpleasant sensation in the body or mind. Uncontrolled pain can increase mortality and morbidity with its negative physiological effects. Effective pain management especially in emergency conditions is essential to keep the patient in optimal conditions and to achieve good clinical results. As most of the injured and traumatic conscious patients with acute pain in emergency situations, need control and perfect pain management during transfer to hospital essential to feel satisfied and improve the quality of service and to decrease mortality and morbidity. Due to some limitation to use opioid drugs in pre-hospital systems, the goal of this study was to evaluate the efficacy of non-opioids drugs in different doses on pre-hospital emergency traumatic conscious patients.
Methods: Infusion of 1 gr IV acetaminophen and 30 mg IV ketorolac were studied separately and in combination 500 mg acetaminophen and 15 mg ketorolac on 95 patients in three separate groups in the pre-hospital pain control system. Patient pain score was collected at 5 intervals.
Results: The results showed that there was no significant difference between the three groups in pain scores reduction finally (p> 0.05). The rate of pain reduction in emergency department is very important and these criteria was significant (p< 0.05).
Conclusion: The results of this study suggest that the combination of ketorolac and acetaminophen reduces pain more rapidly than either alone.
According to our findings we suggest a combination of apotel and ketorolac is injected in advance in moderate to severe conscious traumatic patient before any change in the position of patients if there are not any contraindications.
[2] Potter P, Perry A, Stockert P, Hall A. Fundamentals of nursing. 8th ed: Elsevier; 2012.
[3] Lipsky BA, Berendt AR, Deery HG, Embil JM, Joseph WS, Karchmer AW, et al. Diagnosis and treatment of diabetic foot infections. Plast Reconstr Surg. 2006; 117:212S-38S.
[4] Celotti F, Laufer S. Anti-inflammatory drugs: new multitarget compounds to face an old problem. The dual inhibition concept. Pharmacol Res. 2001; 43(5):429-36.
[5] Jarzyna D, Jungquist CR, Pasero C, Willens JS, Nisbet A, Oakes L, et al. American Society for Pain Management Nursing guidelines on monitoring for opioid-induced sedation and respiratory depression. Pain Manag Nurs. 2011;12(3):118-45.
[6] Stein A, Ben Dov D, Finkel B, Mecz Y, Kitzes R, Lurie A. Single-dose intramuscular ketorolac versus diclofenac for pain management in renal colic. Am J Emerg Med. 1996; 14(4):385-7.
[7] Jelinek GA. Ketorolac versus morphine for severe pain. BMJ. 2000; 321(7271):1236–7.
[8] Wininger SJ, Miller H, Minkowitz HS, Royal MA, Ang RY, Breitmeyer JB, et al. A randomized, double-blind, placebo-controlled, multicenter, repeat-dose study of two intravenous acetaminophen dosing regimens for the treatment of pain after abdominal laparoscopic surgery. Clin Ther. 2010; 32(14):2348-69.
[9] Kehlet H, Dahl JB. The value of "multimodal" or "balanced analgesia" in postoperative pain treatment. Anesth Analg. 1993;77(5):1048-56.
[10] Hyllested M, Jones S, Pedersen JL, Kehlet H. Comparative effect of paracetamol, NSAIDs or their combination in postoperative pain management: a qualitative review. Br J Anaesth. 2002;88(2):199-214.
[11] Livshits A, Machtinger R, David LB, Spira M, Moshe-Zahav A, Seidman DS. Ibuprofen and paracetamol for pain relief during medical abortion: a double-blind randomized controlled study. Fertil Steril. 2009; 91(5):1877-80.
[12] Anand A, Sprenker CJ, Karlnoski R, Norman J, Miladinovic B, Wilburn B, et al. Intravenous acetaminophen vs. ketorolac for postoperative analgesia after ambulatory parathyroidectomy. Scand J Pain. 2013; 4(4):249-53.
[13] Mamoun NF, Lin P, Zimmerman NM, Mascha EJ, Mick SL, Insler SR, et al. Intravenous acetaminophen analgesia after cardiac surgery: A randomized, blinded, controlled superiority trial. J Thorac Cardiovasc Surg. 2016; 152(3):881-9.
[14] Erdogan Kayhan G, Sanli M, Ozgul U, Kirteke R, Yologlu S. Comparison of intravenous ibuprofen and acetaminophen for postoperative multimodal pain management in bariatric surgery: A randomized controlled trial. J Clin Anesth. 2018; 50:5-11.
[15] Xie L, Yang RT, Lv K, Zhou HH, Li Z. Comparison of low pre-emptive oral doses of celecoxib versus acetaminophen for postoperative pain management after third molar surgery: A randomized controlled study. J Oral Maxillofac Surg. 2020; 78(1):75.e1-75.e6.
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Issue | Vol 7 No 1 (2021): Winter | |
Section | Research Article(s) | |
DOI | https://doi.org/10.18502/aacc.v7i1.5477 | |
Keywords | ||
Acetaminophen Emergent patients Ketorolac Pain Score Pre-hospital |
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