Multimodal Pain Control in Headaches Associated With Subarachnoid Hemorrhage.

Area of Science:

• Neuroscience
• Pain Management
• Critical Care Medicine

Background:

• Intractable headaches are common in aneurysmal subarachnoid hemorrhage (aSAH) patients.
• Multimodal pain management is standard for acute and chronic pain.
• Evaluating novel pain regimens is crucial for improving patient outcomes.

Purpose of the Study:

• To assess a new multimodal pain regimen for headaches in aSAH patients.
• To compare opioid utilization and pain scores before and after regimen implementation.
• To determine the efficacy of the multimodal approach in reducing pain and opioid consumption.

Main Methods:

• Retrospective study comparing 104 aSAH patients (pre- and post-multimodal regimen).
• Primary endpoint: morphine milligram equivalent (MME) usage in the first 5 days.
• Secondary endpoint: pain scores during the first 5 days of admission.

Main Results:

• Patients receiving the multimodal regimen (n=65) used significantly more MME (82.5) than those without (n=39, 30.0) (P=0.0053).
• No significant difference was observed in median average pain scores between the groups.
• The multimodal pathway did not decrease overall opioid consumption.

Conclusions:

• The implemented multimodal pain pathway for aSAH-associated headaches did not reduce total morphine equivalent utilization.
• Further research is needed to optimize pain management strategies for aSAH patients.
• Current multimodal approaches may require refinement to effectively manage pain and opioid use.