Change in Pain Score after Administration of Analgesics for Lower Extremity Fracture Pain during Hospitalization.

Autor: Griffioen MA; School of Nursing, University of Delaware, Newark, Delaware. Electronic address: mgriffi@udel.edu., Ziegler ML; College of Health Sciences, University of Delaware, Newark, Delaware., O'Toole RV; School of Medicine, University of Maryland, Baltimore, Maryland., Dorsey SG; School of Nursing, University of Maryland, Baltimore, Maryland., Renn CL; School of Nursing, University of Maryland, Baltimore, Maryland.
Jazyk: angličtina
Zdroj: Pain management nursing : official journal of the American Society of Pain Management Nurses [Pain Manag Nurs] 2019 Apr; Vol. 20 (2), pp. 158-163. Date of Electronic Publication: 2018 Nov 12.
DOI: 10.1016/j.pmn.2018.09.008
Abstrakt: Background: Effective acute pain management following injury is critical to improve short-and long-term patient outcomes. Analgesics can effectively reduce pain intensity, yet half of injury patients report moderate to severe pain during hospitalization.
Purpose: The primary aim of this study was to identify the analgesic, different analgesic combinations, or analgesic and adjuvant analgesic combination that generated the largest percent change from pre- to post-analgesic pain score.
Design: This was a descriptive retrospective cohort study of 129 adults admitted with lower extremity fractures to a trauma center.
Methods: Name, dose, and frequency of analgesics and adjuvant analgesics administered from admission to discharge were collected from medical records. Percent change was calculated from pain scores documented on the 0-10 numeric rating scale.
Results: The analgesic with largest percent change from pre- to post-administration pain score was hydromorphone 2 mg IV (53%) for the emergency department and morphine 4 mg IV (54%) for the in-patient unit. All analgesics administered in the emergency department and ∼50% administered on the in-patient unit produced a minimal (15%) decrease in pain score.
Conclusions: This study revealed that few analgesics administered in the emergency department and the in-patient unit to patients with lower extremity fractures provide adequate pain relief. In the emergency department, all analgesics administered resulted in at least minimal improvement of pain. On the in-patient unit 13 analgesic doses resulted at least minimal improvement in pain while nine doses did not even reach 20% change in pain. Findings from this study can be used guide the treatment of fracture pain in the hospital.
(Copyright © 2019 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE