Pain Management in Trauma: Maximizing Multimodals to Minimize Opioids

The US has been challenged with an opioid crisis, as these medications account for a substantial number of fatal and nonfatal overdoses. Surgeons are on the front lines of this epidemic, balancing the treatment of pain, while confronting the risks of opioids, such as gastrointestinal effects, respiratory distress, delirium, increased hospital length of stay, and potential misuse or diversion. 1 Yorkgitis B.K. Brat G.A. Postoperative opioid prescribing: Getting it RIGHTT. Am J Surg. 2018; 215: 707-711 Abstract Full Text Full Text PDF PubMed Scopus (21) Google Scholar ,2 American College of Surgeons Quality ProgramsBest practices guidelines for acute pain management in trauma patients. Nov 2020. https://www.facs.org/-/media/files/quality-programs/trauma/tqip/acute_pain_guidelines.ashxDate accessed: December 22, 2020 Google Scholar Recently, progress has been made in this battle, as opioid-related deaths fell in 2018 for the first time in decades. 3 Centers for Disease Control and PreventionDrug overdose deaths in the United States, 1999-2018. https://www.cdc.gov/nchs/products/databriefs/db356.htmDate accessed: December 21, 2020 Google Scholar The decrease in opioid-related deaths mirrors opioid prescribing rates, as they have been declining over the recent years. 4 Centers for Disease Control and PreventionPrescribing practices. https://www.cdc.gov/drugoverdose/data/prescribing/prescribing-practices.htmlDate accessed: December 21, 2020 Google Scholar Multi-Modal Analgesic Strategy for Trauma: A Pragmatic Randomized Clinical TrialJournal of the American College of SurgeonsVol. 232Issue 3PreviewAn effective strategy to manage acute pain and minimize opioid exposure is needed for injured patients. In this trial, we aimed to compare 2 multimodal pain regimens (MMPRs) for minimizing opioid exposure and relieving acute pain in a busy, urban trauma center. Full-Text PDF