Citation

Karamchandani K, Klick JC, Dougherty ML, Bonavia A, Allen SR, Carr ZJ. J. Trauma Acute Care Surg. 2019; 87(2): 430-439.

Affiliation

Department of Anesthesiology & Perioperative Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA.

Copyright

(Copyright © 2019, Lippincott Williams and Wilkins)

DOI

10.1097/TA.0000000000002292

PMID

30939572

Abstract

Acute and chronic pain in trauma patients remains a challenging entity, particularly in the setting of the escalating opioid epidemic. It has been reported that chronic opioid use increases the likelihood of hospital admissions as a result of traumatic injuries. Furthermore, patients admitted with traumatic injuries have a greater than average risk of developing opioid use disorder after discharge. Practitioners providing care to these patients will encounter the issue of balancing analgesic goals and acute opioid withdrawal with the challenge of reducing post-discharge persistent opioid use. Additionally, the practitioner is faced with the worrisome prospect that inadequate treatment of acute pain may lead to the development of chronic pain and over-treatment may result in opioid dependence. It is therefore imperative to understand and execute alternative non-opioid strategies to maximize the benefits and reduce the risks of analgesic regimens in this patient population. This narrative review will analyze the current literature on pain management in trauma patients and highlight the application of the multimodal approach in potentially reducing the risks of both short and long-term opioid use. STUDY TYPE: Narrative review LEVEL OF EVIDENCE: Moderate to High.

Language: en