Multimodal Analgesia Decreases Opioid Use in Critically Ill Trauma Patients

Journal of the American College of Surgeons
Kasey L HamrickJeremiah J Duby

Abstract

Opioids are the mainstay of pain management in critically ill trauma patients. However, the risks of opioid use mandate a different approach. Multimodal analgesia employs a combination of opioid and non-opioid agents utilizing different mechanisms that have synergistic effects in treating pain. This study examines the effects of multimodal analgesia on the opioid requirements of critically ill trauma patients. This was a pre-post cohort study of adult trauma intensive care unit patients before and after the implementation of a multimodal pain management order set. Patients were excluded if their hospital stay was less than five days, head abbreviated injury scale score was greater than 1, or pre-injury medications included methadone or buprenorphine. The total oral morphine equivalent (OME) dose was calculated for each 24-hour period on days 2 through 5 of admission and the last 24 hours prior to discharge using standardized ratios. The primary endpoint was cumulative OME doses over the 2nd through 5th days of admission. There were 65 patients in the pre-group and 62 in the post-group. Median cumulative OME dose was significantly lower in the post-group (125.6 mg, Interquartile Range (IQR) 45.0 - 415.0 mg) compared to the pre-g...Continue Reading

Associated Clinical Trials

Citations

Jun 26, 2020·Journal of Burn Care & Research : Official Publication of the American Burn Association·Michael Wright, Jin A Lee
May 28, 2020·The Journal of Trauma and Acute Care Surgery·John A HarvinLillian S Kao
Jan 21, 2021·Journal of Burn Care & Research : Official Publication of the American Burn Association·Sierra R YoungTina L Palmieri
Jan 23, 2021·International Anesthesiology Clinics·Maeve Muldowney, Paul I Bhalla
Mar 17, 2021·AACN Advanced Critical Care·Shanna Fortune, Jennifer Frawley
Apr 4, 2021·Healthcare·Sara J HylandRobert K Cleary
May 11, 2021·Enfermería intensiva·Gemma Via-ClaveroUNKNOWN Grupo de Trabajo de Analgesia, Sedación, Delirio y Contenciones
Jun 9, 2021·Enfermería Intensiva·G Via-ClaveroUNKNOWN Grupo de Trabajo de Analgesia Sedación Delirio y Contenciones
Nov 15, 2021·Journal of Clinical Pharmacology·Kathryn SmithAurora Quaye

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