Pain Following Battlefield Injury and Evacuation: A Survey of 110 Casualties from the Wars in Iraq and Afghanistan

Abstract

Our findings underscore the value of early aggressive pain management after major combat injuries. Increased pain was associated with increased anxiety, distress, and worry during transport, suggesting the need for psychological management along with analgesia. Regional anesthesia techniques while at LRMC contributed to better pain outcomes.

Innovations in the En Route Care of Combat Casualties

“…In addition, a study conducted by Buckenmaier and colleagues (2009) of pain during AE transport used an exploratory mixed methods design which included a survey and semistructured interviews. In this study, in which patients were surveyed after being transported to LRMC in Germany, 65% reported 50% or less pain relief during transport (Buckenmaier et al, 2009). Ground transport, often a bumpy ride to and from the aircraft and medical facilities, also contributes to pain experienced by ill and injured patients.…”

Pain Control in Acute Trauma

“…The work of their group has clearly demonstrated outcomes benefit of regional anesthesia as a component of multimodal analgesia in improving the pain control of wounded soldiers [28]. In addition to improved pain control, the early and successful control of pain may be associated with improvement in the psychological consequences of trauma such as anxiety, chronic pain, and potentially long-term psychological distress [2,3,7,12,13,15,[23][24][25][26][27][28][29][30][31]34].…”

“…In the trauma specifically, Buckenmaier et al have published extensively on the application and benefits of regional anesthesia and aggressive acute pain management in the wounded soldier [10,24,28,[32][33][34][35][36]. The work of their group has clearly demonstrated outcomes benefit of regional anesthesia as a component of multimodal analgesia in improving the pain control of wounded soldiers [28].…”

Pain Management in Military Trauma

“…Increased pain is associated with increased anxiety, distress, and worry, suggesting the need for psychological management along with analgesia. 38 The US Army Institute of Surgical Research asserts:…”