J Korean Soc Emerg Med.  2016 Dec;27(6):602-617. 10.0000/jksem.2016.27.6.602.

The Analysis about Tendency of Emergency Medicine in Pain Control

• Lee KH
• Min MK
• Ryu JH
• Kim YI
• Park MR
• Lee D
• Yeom SR
• Han SK
• Jeong WJ

• KMID: 2369049
• DOI: http://doi.org/10.0000/jksem.2016.27.6.602

Abstract

PURPOSE
Inadequate treatment of pain, which has been termed as "oligoanalgesia", appears to be common phenomenon the emergency department (ED). In order to improve pain recognition and management, a study concerning physician characteristics on pain and pain management is needed.
METHODS
This study was based on a survey that targeted emergency medicine doctors from September to November 2015 (the response rate was 7%). Firstly, the survey showed that physicians preferred medicating on five diseases abdominal pain, cancer, simple musculoskeletal disease, trauma, headache in the ED. Secondly, it demonstrated the criteria used to choose the analgesic treatment in accordance with each disease and the level of pain, which is determined using a numerical rating scale (NRS).
RESULTS
In the cases of abdominal pain that requires surgery, cancer pain, and multiple trauma, physicians preferred using an opioid as the first medication, while non steroidal anti inflammatory drugs (NSAIDs) are prescribed in most of the other cases. Meperidine was the preferred choice as the opioid. For almost diseases, the NSAIDs are selected in the lower NRS cases over the opioid. Physicians deal with pain of patients who are already diagnosed with specific diseases, such as cancer, while they avoid managing pain from those patients who have not been definitively diagnosed with a specific disease.
CONCLUSION
Physicians in the ED prefer the use of NSAIDs as the analgesic treatment, in particular, prescribing meperidine as the preferred opioid. However, it seems that they are hesitant to manage pain without a clear diagnosis.

Keyword

Analgesics; Pain; Pain management; Opioid

MeSH Terms

Abdominal Pain
Analgesics
Anti-Inflammatory Agents, Non-Steroidal
Diagnosis
Emergencies*
Emergency Medicine*
Emergency Service, Hospital
Headache
Humans
Meperidine
Multiple Trauma
Musculoskeletal Diseases
Pain Management
Analgesics
Anti-Inflammatory Agents, Non-Steroidal
Meperidine