Multimodal oral analgesia for non-severe trauma patients: evaluation of a triage-nurse directed protocol combining methoxyflurane, paracetamol and oxycodone.

Autor:	Viglino, Damien, Termoz Masson, Nicolas, Verdetti, Agnès, Champel, Flore, Falcon, Cédric, Mouthon, Alexis, Mabiala Makele, Prudence, Collomb Muret, Roselyne, Maindet Dominici, Caroline, Maignan, Maxime
Předmět:	INHALATION anesthetics NONPARAMETRIC statistics MEDICAL triage HOSPITAL emergency services ANALGESICS ACETAMINOPHEN ORAL drug administration PATIENT satisfaction OXYCODONE TREATMENT effectiveness NURSES DISEASE prevalence RESEARCH funding WOUNDS & injuries LONGITUDINAL method
Zdroj:	Internal & Emergency Medicine; Oct2019, Vol. 14 Issue 7, p1139-1145, 7p
Abstrakt:	Insufficient analgesia affects around 50% of emergency department patients. The use of a protocol helps to reduce the risk of oligoanalgesia in this context. Our objective was to describe the feasibility and efficacy of a multimodal analgesia protocol (combining paracetamol, oxycodone, and inhaled methoxyflurane) initiated by triage nurse. We performed a prospective, observational study in an emergency department (Grenoble Alpes University Hospital, France) between December 2017 and April 2018. Adult non-severe trauma patients with a numerical pain rating scale (NRS) score ≥ 4 were included. The primary efficacy criterion was the proportion of patients with an NRS score ≤ 3 at 15 min. Pain intensity was measured for 60 min and during radiography. Data on adverse events and satisfaction were recorded. A total of 200 adult patients were included (median [interquartile range (IQR)] age: 32 [23-49] years; 126 men (63%)). Sixty-six patients (33%) reported an NRS score ≤ 3 at 15 min. The time required to achieve a decrease of at least 2 points in the NRS score was 10 (5-20) min. The median [IQR] pain intensity was 4 [2-5] before radiography and 4 [2-6] during radiography. Adverse events were frequent (n = 128, 64%). No serious adverse events were reported. The patients and caregivers reported good levels of satisfaction. The administration of a nurse-driven multimodal analgesia protocol (combining paracetamol, oxycodone, and methoxyflurane) was feasible on admission to the emergency department. It rapidly produced long-lasting analgesia in adult trauma patients.Trial registration: NCT03380247. [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
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