Pain Management in the Unstable Trauma Patient

Abstract

Review the current literature regarding the optimal approach to pain control in unstable trauma patients, specifically focusing on the initial management of pain and rapid transition to multi-modal agents. There is a clear benefit to multi-modal analgesia instituted as rapidly as possible in trauma patients. While early management of pain depends upon the use of short-acting IV opioids, the rapid transition to adjunctive pain control strategies is optimal. The benefits include not only improved patient experience but also improved physiologic parameters and lower long-term risk of chronic pain and disability. The initial management of pain in unstable trauma patients is focused on titrating short-acting IV opioids to effect. Rapid institutions of multi-modal pain control, however, can improve short-term pain management while reducing the physiologic load imposed by uncontrolled pain and reduce the risk of long-term chronic pain and opioid misuse.