Yıl: 2023 Cilt: 8 Sayı: 2 Sayfa Aralığı: 185 - 191 Metin Dili: İngilizce DOI: 10.26453/otjhs.1179991 İndeks Tarihi: 13-06-2023

Examination of Pain Assessment and Multimodal Analgesia Records in Trauma Patients

Öz:
Objective: This study aimed to reduce the side effects of multiple pain sources and investigate the effectiveness of multiple analgesics in trauma pain. Materıals and Methods: The research was conducted with nurse observation forms of 190 trauma patients hospitalised in the emergency unit of a university hospital between March 1 and September 30, 2019. In the statistical analysis, per cent mean, min-max values and standard deviation were used for descriptive data. Paired Simle t-test was used for repeated measurements of the double-dependent variable. Results: The mean age of the patients included in the study was 40.94±15.18 years, and 65.8% were male. While the cause of 47.9% of traumas is traffic accidents, 37.9% of the patients have multiple traumas. The pain was evaluated in 55.7% of the patients, and multimodal analgesia was applied in 71.6% of the patients, and it was determined that the pain of the patients decreased. Conclusions: Accordingly, this study supports the treatment of trauma pain with multiple sources of pain with a multimodal analgesia approach. In addition, the pain was not appropriately assessed as recommended in the acute pain guidelines. Therefore, nurses should increase awareness of pain assessment records for effective pain management.
Anahtar Kelime: Emergency department multimodal analgesia nursing pain

Travma Hastalarında Multimodal Analjezi ve Ağrı Değerlendirme Kayıtlarının İncelenmesi

Öz:
Amaç: Bu çalışmada, travma hastalarında ağrı değerlendirmesi ve multimodal analjezi kayıtlarının incelenmesi amaçlanmıştır. Materyal ve Metot: Araştırma 1 Mart-30 Eylül 2019 tarihleri arasında, bir üniversite hastanesinin acil ünitesinde yatan, 190 travmalı hastanın hemşire gözlem formlarıyla yapıldı. Araştırmanın verileri Hasta Bilgi Formu ve Multimodal Analjezi Değerlendirme Formu ile toplanmıştır. Verilerin istatistiksel analizinde tanımlayıcı verilerde yüzde ortalama, min-maks değerleri ve standart sapma kullanıldı. İkili bağımlı değişkene ait tekrarlı ölçümler için Paired Simle t- testi kullanıldı. Bulgular: Araştırmaya dâhil edilen hastaların yaş ortalaması 40,94±15,18 olup, %65,8’i erkektir. Travmaların %47,9’unun nedeni trafik kazaları iken, hastaların %37,9’unda multiple travma mevcuttur. Hastaların %55,7’sine ağrı değerlendirmesi yapılmış olup, %71,6’sına multimodal analjezi uygulandığı ve hastaların ağrısının azaldığı saptandı. Ayrıca, gözlem formlarında farmakolojik olmayan ağrı tedavisine ilişkin hemşire kaydına rastlanmadı. Sonuç: Buna göre, bu çalışma travma ağrısının çoklu ağrı kaynakları ile multimodal analjezi yaklaşımı ile tedavisini desteklemektedir. Ek olarak, ağrı, akut ağrı kılavuzlarında önerildiği gibi uygun şekilde değerlendirilmemiştir. Bu nedenle hemşireler, etkili ağrı yönetimi için ağrı değerlendirme kayıtlarının farkındalığını arttırmalıdır.
Anahtar Kelime: Acil Servis ağrı hemşirelik multi- modal analjezi

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Amini K, Fakhri AS, Salehi H, Bakhtavar EH, Rahmani F. Mortality prediction in multiple trau- ma patients using GAP, RTS and NTS models. trauma monthly. 2021;26(5):252-257. 10.30491/ TM.2021.262592.1212
  • 2. Yu Z, Xu F, Chen D. Predictive value of Modi- fied Early Warning Score (MEWS) and Revised Trauma Score (RTS) for the short-term prognosis of emergency trauma patients: a retrospective study. BMJ Open. 2021;11(3):e041882. doi:10.1136/bmjopen-2020-041882
  • 3. Erden S, Arslan S, Deniz S, Kaya P, Gezer D. A review of postoperative pain assessment records of nurses. Appl Nurs Res. 2017;38:1-4. doi:10.1016/j.apnr.2017.08.003
  • 4. Reisli R, Akkaya ÖT, Arıcan Ş, et al. Akut pos- toperatif ağrının farmakolojik tedavisi: Türk Al- goloji-Ağrı Derneği klinik uygulama kılavuzu [Pharmachologic treatment of acute postoperati- ve pain: A clinical practice guideline of The Tur- kish Society of Algology]. Agri. 2021;33(Suppl 1):1-51. doi:10.14744/agri.2021.60243
  • 5. Varndell W, Fry M, Elliott D. Pain assessment and interventions by nurses in the emergency department: A national survey. J Clin Nurs. 2020;29(13-14):2352-2362. doi:10.1111/ jocn.15247
  • 6. Acar K, Acar H, Demir F, Aslan EF. Determı- nıng the ıncıdence of postsurgıcal paın and amo- unt of analgesıc use postsurgıcal paın and anal- gesıc. ACU Sağlık Bil Derg. 2016;(2):85-91.
  • 7. Peek J, Smeeing DPJ, Hietbrink F, Houwert RM, Marsman M, de Jong MB. Comparison of anal- gesic interventions for traumatic rib fractures: a systematic review and meta-analysis. Eur J Trau- ma Emerg Surg. 2019;45(4):597-622. doi:10.1007/s00068-018-0918-7
  • 8. Baker EJ, Lee GA. A retrospective observational study examining the effect of thoracic epidural and patient controlled analgesia on short-term outcomes in blunt thoracic trauma ınjuries. Medicine (Baltimore). 2016;95(2):2374. doi:10.1097/MD.0000000000002374
  • 9. Chou R, Gordon DB, de Leon-Casasola OA, et al. Management of postoperative pain: a clinical practice guideline from the American Pain Soci- ety, the American Society of Regional Anesthe- sia and Pain Medicine, and the American Society of Anesthesiologists' Committee on Regional Anesthesia, Executive Committee, and Administ- rative Council. J Pain. 2016;17(2):131-157. doi:10.1016/j.jpain.2015.12.008
  • 10. Thomazeau J, Rouquette A, Martinez V, et al. Acute pain Factors predictive of post operative pain and opioid requirement in multimodal anal- gesia following knee replacement. Eur J Pain. 2016;20(5):822-832. doi:10.1002/ejp.808
  • 11. Akarca, FK, Karcıoğlu Ö, Korkmaz T, Erbil B, Demir ÖF. Analgesic treatment in patients with acute extremity trauma and effect of training. Tr- J Emerg Med. 2012;12(2):69-76. doi: 10.5505/1304.7361.2012.50480
  • 12. Yang J, Bauer BA, Wahner-Roedler DL, Chon TY, Xiao L. The modified WHO analgesic lad- der: Is ıt appropriate for chronic non-cancer pain? J Pain Res. 2020;13:411-417. doi:10.2147/ JPR.S244173
  • 13. American Society of Anesthesiologists Task For- ce on Acute Pain Management. Practice guideli- nes for acute pain management in the perioperati- ve setting: an updated report by the American Society of Anesthesiologists Task Force on Acu- te Pain Management. Anest. 2012;116:248-273. doi:10.1097/ALN.0b013e31823c1030
  • 14. Galvagno SM Jr, Smith CE, Varon AJ, et al. Pain management for blunt thoracic trauma: A joint practice management guideline from the Eastern Association for the Surgery of Trauma and Trau- ma Anesthesiology Society. J Trauma Acute Ca- re Surg. 2016;81(5):936-951. doi:10.1097/ TA.0000000000001209
  • 15. Burton SW, Riojas C, Gesin G, et al. Multimodal analgesia reduces opioid requirements in trauma patients with rib fractures. J Trauma Acute Care Surg. 2021;92(3):588-596. doi:10.1097/ TA.0000000000003486
  • 16.Hatton GE, Kregel HR, Pedroza C, et al. Age- related opioid exposure in trauma: A secondary analysis of the multimodal analgesia strategies for trauma (MAST) randomized trial. Ann Surg. 2021;274(4):565-571. doi:10.1097/ SLA.0000000000005065
  • 17.Hamrick KL, Beyer C, Lee JA, Cocanour C, Duby JJ. Multimodal analgesia and opioid use in critically ill trauma patients. Journal of the Ame- rican College of Surgeons, 2019;228(5):769-775. doi:10.1016/j.jamcollsurg.2019.01.020
  • 18.Aslan FE, Aygin D, Sarıyıldız D. The satısfac- tıon level of patıents wıth trauma on paın mana- gement. Turkiye Klinikleri Journal of Medical Sciences, 2007;27(5):687-694.
  • 19.Hatton GE, Bell C, Wei S, Wade CE, Kao LS, Harvin JA. Do early non-steroidal anti- inflammatory drugs for analgesia worsen acute kidney injury in critically ill trauma patients? An inverse probability of treatment weighted analy- sis. J Trauma Acute Care Surg. 2020;89(4):673- 678. doi:10.1097/TA.0000000000002875
  • 20.Baldemır R, Akçaboy EY, Çelık Ş, Noyan Ö, Akçaboy ZN, Baydar M. An assessment of phy- sicians attitudes toward opioid usage and opiop- hobia: Results of a survey from a training and research hospital. Ağrı. 2019;31(1):23-31. doı: 10.5505/agri.2018.03411
  • 21.Özel F, Samancıoğlu Bağlama S. The effect of pain management barriers in emergency depar- ment. Kocaeli Med J. 2018;7(3):14-20.
  • 22.Stone RH, Griffin B, Fusco R, Vest K, Tran T, Gross S. Factors affecting contraception access and use in patients with opioid use disorder. The Journal of Clinical Pharmacology. 2020;60,63- 73. doi:10.1002/jcph.1772
  • 23.Berben SA, Schoonhoven L, Meijs, TH, Van Vugt AB, Van Grunsven PM. Prevalence and relief of pain in trauma patients in emergency medical services. Clin J Pain. 2013;29(1):64-69. doi:10.1097/AJP.0b013e3182454a9e
  • 24.Oddo M, Crippa IA, Mehta S, Menon D, Payen J, Taccone F, et al. Optimizing sedation in pati- ents with acute brain injury. Crit Care. 2016;20 (1):128. doi:10.1186/s13054-016-1294-5
  • 25.Aminiahidashti H, Shafiee S, Hosseininejad SM, et al. Propofol-fentanyl versus propofol-ketamine for procedural sedation and analgesia in patients with trauma. Am J Emerg Med. 2018;36 (10):1766-1770. doi:10.1016/j.ajem.2018.01.080
  • 26.Algın A, Hökenek NM, Yıldırım Ç. The use of ketamine in trauma patients. Ankara Medical Journal, 2019;19.4:776-783. doi.org/10.17098/ amj.652006
  • 27. Samarkandi OA. Knowledge and attitudes of nurses toward pain management. Saudi J Ana- esth. 2018;12(2):220-226. doi:10.4103/ sja.SJA_587_17
  • 28. Rafati F, Soltaninejad M, Aflatoonian MR, Mas- hayekhi F. Postoperatıve paın: management and documentatıon by ıranıan nurses. Mater Socio- med. 2016;28(1):36-40. doi:10.5455/ msm.2016.28.36-40
  • 29. Hsu JR, Mir H, Wally MK, Seymour RB. Clini- cal practice guidelines for pain management in acute musculoskeletal injury. J Orthop Trauma. 2019;33(5):158-182. doi:10.1097/ BOT.0000000000001430
  • 30. Varlık M, Eroğlu ES, Özdemir S, Kahraman HA, Yıldız NM, Bozan Ö. Evaluation of Paiıents who applied to the Emergency Department by Intra- Vehicle Traffic Accident. Firat Med J. 2019;24. (4):186-192.
APA TURA İ, erden s (2023). Examination of Pain Assessment and Multimodal Analgesia Records in Trauma Patients. , 185 - 191. 10.26453/otjhs.1179991
Chicago TURA İLKNUR,erden sevilay Examination of Pain Assessment and Multimodal Analgesia Records in Trauma Patients. (2023): 185 - 191. 10.26453/otjhs.1179991
MLA TURA İLKNUR,erden sevilay Examination of Pain Assessment and Multimodal Analgesia Records in Trauma Patients. , 2023, ss.185 - 191. 10.26453/otjhs.1179991
AMA TURA İ,erden s Examination of Pain Assessment and Multimodal Analgesia Records in Trauma Patients. . 2023; 185 - 191. 10.26453/otjhs.1179991
Vancouver TURA İ,erden s Examination of Pain Assessment and Multimodal Analgesia Records in Trauma Patients. . 2023; 185 - 191. 10.26453/otjhs.1179991
IEEE TURA İ,erden s "Examination of Pain Assessment and Multimodal Analgesia Records in Trauma Patients." , ss.185 - 191, 2023. 10.26453/otjhs.1179991
ISNAD TURA, İLKNUR - erden, sevilay. "Examination of Pain Assessment and Multimodal Analgesia Records in Trauma Patients". (2023), 185-191. https://doi.org/10.26453/otjhs.1179991
APA TURA İ, erden s (2023). Examination of Pain Assessment and Multimodal Analgesia Records in Trauma Patients. Online Türk Sağlık Bilimleri Dergisi, 8(2), 185 - 191. 10.26453/otjhs.1179991
Chicago TURA İLKNUR,erden sevilay Examination of Pain Assessment and Multimodal Analgesia Records in Trauma Patients. Online Türk Sağlık Bilimleri Dergisi 8, no.2 (2023): 185 - 191. 10.26453/otjhs.1179991
MLA TURA İLKNUR,erden sevilay Examination of Pain Assessment and Multimodal Analgesia Records in Trauma Patients. Online Türk Sağlık Bilimleri Dergisi, vol.8, no.2, 2023, ss.185 - 191. 10.26453/otjhs.1179991
AMA TURA İ,erden s Examination of Pain Assessment and Multimodal Analgesia Records in Trauma Patients. Online Türk Sağlık Bilimleri Dergisi. 2023; 8(2): 185 - 191. 10.26453/otjhs.1179991
Vancouver TURA İ,erden s Examination of Pain Assessment and Multimodal Analgesia Records in Trauma Patients. Online Türk Sağlık Bilimleri Dergisi. 2023; 8(2): 185 - 191. 10.26453/otjhs.1179991
IEEE TURA İ,erden s "Examination of Pain Assessment and Multimodal Analgesia Records in Trauma Patients." Online Türk Sağlık Bilimleri Dergisi, 8, ss.185 - 191, 2023. 10.26453/otjhs.1179991
ISNAD TURA, İLKNUR - erden, sevilay. "Examination of Pain Assessment and Multimodal Analgesia Records in Trauma Patients". Online Türk Sağlık Bilimleri Dergisi 8/2 (2023), 185-191. https://doi.org/10.26453/otjhs.1179991