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[Pain management in subarachnoid haemorrhage: a survey of French analgesic practices]
M Binhas1, P Walleck, N El Bitar
1Service d'anesthésie-réanimation chirurgicale, SAMU-SMUR 94, CHU Henri-Mondor, Assistance publique-Hôpitaux de Paris, université Paris-XII, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil cedex, France. michele.binhas@hmn.aphp.fr
Objective:
Pain management in patients having a subarachnoid haemorrhage was assessed in French intensive care unit of neurosurgical centres.
Study Design:
Nationwide survey.
Methods:
A standardized postal questionnaire was sent to senior doctor of every neurosurgical centres in France inquiring pain scores assessment, analgesics used and their routes of administration, centre's opinion about efficacy of pain management.
Results:
Of the 34 centres, 24 returned completed questionnaires. Fifty four per cent of the centres evaluated pain intensity with a non valid pain score. In the case of patients in the comatose, pain was not evaluated in fifty four per cent of the centres. Paracetamol and morphine were the most currently used analgesics drugs. Morphine was administered subcutaneously by 75% of the centres. Six centres used also PCA. Thirty-seven percent of the centres were reluctant to use opioids and 75% to use NSAIDS.
Conclusion:
The majority of the centres considered pain management in patient suffering from subarachnoid haemorrhage (SAH) was not optimal and stressed the need to establish a well validated pain rating scale dedicated to SAH patients.
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