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Determining Pain Detection and Tolerance Thresholds Using an Integrated, Multi-Modal Pain Task Battery
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Implementation of a multi-modal pain regimen to decrease inpatient opioid exposure after injury.

Shuyan Wei1, Charles Green2, Van Thi Thanh Truong2

  • 1Center for Translational Injury Research, McGovern Medical School at the University of Texas Health Science Center, Houston, TX, USA; Department of Surgery, McGovern Medical School at the University of Texas Health Science Center, Houston, TX, USA; Center for Surgical Trials and Evidence-based Practice, USA.

American Journal of Surgery
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PubMed
Summary
This summary is machine-generated.

A multi-modal pain regimen (MMPR) significantly reduced inpatient opioid exposure in trauma patients. This approach lowered opioid administration and improved pain scores, offering a safer alternative for managing pain after injury.

Keywords:
Multi-modal pain regimenOpioidPain managementTrauma

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Area of Science:

  • Trauma surgery
  • Pain management
  • Pharmacology

Background:

  • Opioid overreliance is a significant concern in trauma care.
  • Multi-modal pain regimens aim to reduce opioid consumption.
  • Implementing new pain management strategies is crucial for patient outcomes.

Purpose of the Study:

  • To evaluate the effectiveness of a multi-modal pain regimen (MMPR) in reducing in-hospital opioid exposure.
  • To assess the impact of MMPR on opioid prescriptions at discharge.
  • To determine if MMPR affects patient-reported pain scores (Numerical Rating Scale - NRS).

Main Methods:

  • Adult patients with rib fractures at a level-1 trauma center were studied from 2010-2017.
  • Data included opioid administration (MME) and NRS pain scores.
  • Bayesian generalized linear models analyzed the effect of MMPR on daily MME.

Main Results:

  • A significant reduction in median MME per patient day was observed post-MMPR implementation (37 MME vs. 60 MME).
  • Total MME decreased by 31% in 2017 compared to 2010.
  • Average NRS pain scores decreased by 0.8 points.

Conclusions:

  • The MMPR effectively reduced inpatient opioid exposure in trauma patients.
  • Opioid use reduction was equivalent to 11 mg less oxycodone or 17 mg less hydrocodone per patient daily.
  • MMPR was associated with improved pain control, indicated by lower NRS scores.