- A multimodal analgesia pain management program that combined opioid and nonopioid agents significantly reduced the overall opioid dose received by critically ill trauma patients without compromising patient comfort.
Why this matters
- Multimodal analgesia has shown positive results in other patient populations, but had not been studied in critically ill trauma patients.
- This retrospective pre-post cohort study evaluated critically injured patients with trauma who were admitted to the intensive care unit pre- (n=65) and postimplementation (n=62) of a multimodal pain management order set.
- Funding: None disclosed.
- Cumulative oral morphine equivalent (OME) dose was significantly lower in the postgroup (125.6 mg; interquartile range [IQR], 45.0-415.0 mg) vs pregroup (481.5 mg; IQR, 174.8-881.3 mg; P<.001>
- Patients receiving ≥3 multimodal agents had a lower cumulative OME dose (116.3 mg; IQR, 52.5-496.5 mg) vs those who were receiving 1-2 (363 mg; IQR, 115.5-743 mg) or 0 (479 mg; IQR, 185-736.5 mg; P=.024) multimodal agents.
- Mean pain score on hospital day 5 (4.48±0.34 vs 3.50±0.38; P=.058) or at hospital discharge (3.43±0.34 vs 3.56±0.32; P=.789) was not different between pre- and postgroup.
- Single-center study.
- Data on long-term opioid use not included.
Coauthored with Antara Ghosh, PhD