Encuesta nacional sobre dolor en las urgencias hospitalarias

Barrientos, Fernando Caba; Alcalá, M.C. Benito; Pérez, Antonio Montes; Sánchez, Jaime; Liébana, R. de la Torre; Ferrí, César Margarit

doi:10.4321/s1134-80462014000100002

Cited by 10 publications

(5 citation statements)

References 24 publications

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“…Remarkably, in the present study opiates were the least used analgesics to control pain in older patients. This is in line with the results of a previous survey about pain management in Spanish EDs answered by emergency physicians, which showed that major opiates were administered in 16.9% of patients with pain, weak opioids in 25.4% and paracetamol/NSAID in 72.3% [22]. The lack of sex differences in opioid use has recently been reported in a population-based study in which, despite the high variability in opioid use across different settings, men and women had a similar likelihood of receiving opioids [23].…”

Section: Discussionsupporting

confidence: 91%

Sex- and age-related patterns in the use of analgesics in older patients in the emergency department

Miró,

Osorio,

Alquézar-Arbé

et al. 2023

European Journal of Emergency Medicine

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Background Treatment of acute pain in older patients is a common challenge faced in emergency departments (EDs). Despite many studies that have investigated chronic analgesic use in the elderly, data on patterns of acute use, especially in EDs, of analgesics according to patient characteristics is scarce. Objective To investigate sex- and age-related patterns of analgesic use in the Spanish EDs and determine differences in age-related patterns according to patient sex. Design A secondary analysis of the Emergency Department and Elderly Needs (EDEN) multipurpose cohort. Setting Fifty-two Spanish EDs (17% of Spanish EDs covering 25% of Spanish population) Participants All patients’ ≥65 years attending ED during 1 week (April 1–7, 2019). Patient characteristics recorded included age, sex, chronic treatment with non-steroidal anti-inflammatory drugs (NSAIDs) and opiates, comorbidity, dependence, dementia, depression, ability to walk and previous falls. Analgesics used in the ED were categorized in three groups: non-NSAID non-opioids (mainly paracetamol and metamizole, PM), NSAIDs, and opiates. Outcome measures Frequency of analgesic use was quantified, and the relationship between sex and age and analgesic use (in general and for each analgesic group) was assessed by unadjusted and adjusted logistic regression and restricted cubic spline models. Interaction between sex and age was explored. Main results We included 24 573 patients, and 6678 (27.2%) received analgesics in the ED: 5551 (22.6%) PM, 1661 (6.8%) NSAIDs and 937 (3.8%) opiates (1312 received combinations). Analgesics were more frequently used in women (adjusted OR = 1.076, 95%CI = 1.014–1.142), as well as with NSAID (1.205, 1.083–1.341). Analgesic use increased with age, increasing PM and decreasing NSAIDs use. Opiate use remained quite constant across age and sex. Interaction of sex with age was present for the use of analgesics in general (P = 0.006), for PM (P < 0.001) and for opiates (P = 0.033), with higher use of all these analgesics in women. Conclusion Use of analgesics in older individuals in EDs is mildly augmented in women and increases with age, with PM use increasing and NSAIDs decreasing with age. Conversely, opiate use is quite constant according to sex and age. Age-related patterns differ according to sex, with age-related curves of women showing higher probabilities than those of men to receive any analgesic, PM or opiates.

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Section: Discussionsupporting

confidence: 91%

Sex- and age-related patterns in the use of analgesics in older patients in the emergency department

Miró,

Osorio,

Alquézar-Arbé

et al. 2023

European Journal of Emergency Medicine

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“…Designing an activecontrolled trial in this setting is challenging because of variability in the management of trauma pain nationally, regionally, and even at the local level within hospitals. 32 In Spain, there is no established standard analgesic treatment or clinical guidelines for the emergency treatment of trauma pain; thus, it was necessary to use a pragmatic open-label study design. The most frequently used analgesics in Spanish EDs are nonsteroidal antiinflammatory drugs (generally administered parenterally), with a relatively low level of opioid use.…”

Section: Discussionmentioning

confidence: 99%

Inhaled Methoxyflurane Provides Greater Analgesia and Faster Onset of Action Versus Standard Analgesia in Patients With Trauma Pain: InMEDIATE: A Randomized Controlled Trial in Emergency Departments

Borobia

Collado

Cardona

et al. 2020

Annals of Emergency Medicine

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Study objective:The objective of the InMEDIATE study was to evaluate the change in intensity of traumatic pain over the first 20 min in adult patients treated with methoxyflurane versus standard analgesic treatment in Spain. This the first randomized, activecontrolled, multicenter trial of methoxyflurane in the emergency setting in Europe.Methods: This was a randomized, controlled study that enrolled adult patients with acute moderate to severe (score !4 on the 11-point Numeric Rating Scale) trauma-associated pain in 14 Spanish emergency departments. Patients were randomized 1:1 to methoxyflurane (up to 2Â3 mL) or standard analgesic treatment. Coprimary endpoints were the change from baseline in Numeric Rating Scale pain intensity score during the first 20 minutes of treatment and time to first pain relief.Results: Three hundred five patients were randomized (methoxyflurane 156; standard analgesic treatment 149). Most patients in the standard analgesic treatment group (70%) received intravenous first-step analgesics and 9.4% of patients were treated with opioids. Mean decrease from baseline in Numeric Rating Scale pain intensity score was greater for methoxyflurane than standard analgesic treatment at all points, with a significant treatment difference overall up to 20 minutes (repeated-measures model 2.47 versus 1.39; treatment difference 1.00; 95% confidence interval 0.84 to 1.32). Median time to first pain relief was significantly shorter for methoxyflurane than standard analgesic treatment (3 versus 10 minutes). Methoxyflurane achieved better patient and clinician ratings for pain control and comfort of treatment than standard analgesic treatment and exceeded patient and clinician expectations of treatment in, respectively, 77% and 72% of cases compared with 38% and 19% for standard analgesic treatment. Conclusion:These results support consideration of methoxyflurane as a nonnarcotic, easy-to-administer, rapid-acting, first-line alternative to currently available analgesic treatments for trauma pain.

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“…Currently, pain is one of the main reasons for consultation in both primary care and hospital emergencies (Arrebola, García‐Delgado, Labrador‐Barba, Orera‐Peña & Martínez‐Martínez, 2016; Caba‐Barrientos, Benito‐Alcalá, Montes‐Pérez, Aguilar‐Sánchez de la Torre‐Liébana, R., & Margarit‐Ferri, 2014). Despite the fact that acute pain plays an important protective biological role as an alarm mechanism which prevents further damage to the organism experiencing pain (Chapman & Vierck, 2017; López‐Silva, Sánchez‐de Enciso, Rodríguez‐Fernández & Vázquez‐Seijas, 2007), sometimes pain can arise due to the application of certain types of treatments and certain types of diagnostic tests (Barroso, Santos, Santos, Nunes & Lucas, 2020; Boerner, Birnie, Chambers et al ., 2015; Martín‐Pintado‐Zugasti, López‐López, González Gutiérrez et al ., 2017), therefore losing its protective value and becoming a potential barrier for the preservation of the organism's health.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of spontaneous pain coping strategies for acute pain management: A laboratory study

López-López

Gutiérrez

Hernández

et al. 2022

Scandinavian J Psychology

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The aim of the present study has been to analyze the relationship between the use of not previously trained, diverse acute pain coping strategies and levels of pain intensity and pain tolerance in a group of healthy participants. Previous research has analyzed the usefulness of the training of these strategies after several training sessions, but adequate patient training requires a great deal of time. Two hundred and forty healthy people participated in the study. Pain coping strategies was evaluated with a version of CSQ-S. Subsequently, the participants completed a cold pressor test and tolerance test. After that, subjects filled in the adaptation of the CSQ-S about the strategies which they had employed throughout the test. Correlation analyses showed a positive relationship between pain intensity and catastrophizing, distractor behaviors, hoping and ignoring the pain. Pain tolerance correlated with self-instructions, ignoring the pain, reinterpreting the pain, catastrophizing and faith and praying. Regression analyses showed that catastrophizing was found to be the strategy that most predicts the variance of pain intensity, and catastrophizing (negative) and ignoring the pain (positive) and praying (negative) were the most predictive ones for pain tolerance. This is the first laboratory study that identifies the more useful pain coping strategies which can be used by patients without previous training in an acute pain context. The results of this study could be useful in the development of protocols for nurses and other health professionals, especially for situations where potentially painful techniques are to be applied to patients.

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Encuesta nacional sobre dolor en las urgencias hospitalarias

Cited by 10 publications

References 24 publications

Sex- and age-related patterns in the use of analgesics in older patients in the emergency department

Sex- and age-related patterns in the use of analgesics in older patients in the emergency department

Inhaled Methoxyflurane Provides Greater Analgesia and Faster Onset of Action Versus Standard Analgesia in Patients With Trauma Pain: InMEDIATE: A Randomized Controlled Trial in Emergency Departments

Effectiveness of spontaneous pain coping strategies for acute pain management: A laboratory study

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