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Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
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An Experimental Paradigm for the Prediction of Post-Operative Pain PPOP
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Multi-modal Pain Control Protocol Decreases Narcotic Consumption in an Inpatient Trauma Population.

Joel M L Biester1, Caleb J Mentzer1, Shayne R Caswell1

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Implementing a multi-modal pain control (MMPC) protocol significantly reduced opioid consumption in injured patients. This approach effectively managed pain without increasing opioid-related complications, offering a safer alternative for post-operative care.

Keywords:
multi-modalopioid usepain managementtrauma

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Area of Science:

  • Trauma Surgery
  • Pain Management
  • Pharmacology

Background:

  • Opioid dependence is a significant concern following surgery or trauma.
  • Traditional pain management strategies may contribute to increased opioid use.
  • An opioid-minimizing, multi-modal pain control (MMPC) protocol was developed and implemented.

Purpose of the Study:

  • To evaluate the effectiveness of an MMPC protocol in reducing opioid consumption.
  • To compare opioid utilization in MMPC versus standard pain control (STP) groups.
  • To assess the impact of MMPC on pain scores and opioid-related complications.

Main Methods:

  • Adult patients admitted to the Acute Care Surgery (ACS) service between specified periods were analyzed.
  • Patients were divided into Standard Pain Control (STP) and Multi-Modal Pain Control (MMPC) groups based on admission year.
  • Primary outcome: daily opioid use in morphine milligram equivalents (MME); Secondary outcomes: pain scores, complications, mortality, and length of stay.

Main Results:

  • The MMPC group demonstrated significantly lower daily opioid utilization (22.5 MMEs/d) compared to the STP group (60 MMEs/d).
  • Patient populations differed, with the MMPC group being older and less injured.
  • No significant differences were observed in daily pain scores or secondary outcomes between the groups.

Conclusions:

  • The MMPC protocol effectively reduced opioid consumption in injured patients.
  • Equivalent pain control was achieved with the MMPC protocol compared to standard care.
  • MMPC represents a viable strategy for minimizing opioid use in acute care surgery settings.