Opioid Administration in the Trauma Bay for Minor Injuries Does Not Improve Disposition.

Autor:	Marchioli MD; Department of Surgery, The Ohio State University School of Medicine, Columbus, OH, USA., Baselice HE; Department of Surgery, The Ohio State University, Columbus, OH, USA., Kirk SM; Department of Pharmacology, The Ohio State University, Columbus, OH, USA., Reichert EM; Department of Pharmacology, The Ohio State University, Columbus, OH, USA., Valdez CL; Department of Surgery, The Ohio State University, Columbus, OH, USA.
Jazyk:	angličtina
Zdroj:	The American surgeon [Am Surg] 2024 Sep 13, pp. 31348241285190. Date of Electronic Publication: 2024 Sep 13.
DOI:	10.1177/00031348241285190
Abstrakt:	Objectives: Opioid usage in the trauma bay is a common practice for pain management. We evaluated the administration of opioids to patients with minimal injury to determine disposition and factors for opioid administration. Methods: A retrospective study at a single institution was conducted utilizing records of trauma activations with an ISS of 3 or less between 1/1/2022 and 10/29/2022. Patients who are incarcerated, pregnant, or received an opioid prior to arrival were excluded. Categorical variables were analyzed using chi-square tests, and continuous variables were analyzed using t -tests. Results: 557 patients met inclusion criteria. One in five patients were administered an opioid (22%). The majority of patients who received opioids were between the ages of 25 and 44 (OR 1.218 [.693, 2.141]), black (OR 3.077 [2.066, 4.584]), and had Medicaid insurance (OR 1.390 [.883, 2.187]). Patients who received an opioid reported a higher pain level (8 [6, 9] v 5 [2, 8], P = .0001), despite no difference in ISS. No significant difference was found in patient dispositions ( P = .1759). When fentanyl was administered, doses greater than 50 mcg were administered to highest activation level trauma patients (40% v 10% P = .0001). Conclusion: Opioid administration for patients with minor injuries does not improve patient disposition. The majority of patients with minor injuries being treated with opioids are young, black, and Medicaid patients. This research suggests consideration for establishing a non-opioid analgesic medication as first-line pain management for patients without evidence of significant injury on initial evaluation. Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
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