Assessment of pain management intervention for treatment of long bone fractures in tertiary care hospital

Authors

  • Elizabeth C. Sada Department of Emergency Medicine, Bharati Hospital, Dhanakawadi, Pune, Maharashtra, India
  • Firdaus Bhot Department of Emergency Medicine, Bharati Hospital, Dhanakawadi, Pune, Maharashtra, India
  • Rohit Kanishetty Department of Emergency Medicine, Bharati Hospital, Dhanakawadi, Pune, Maharashtra, India

DOI:

https://doi.org/10.18203/2349-3933.ijam20194209

Keywords:

Follow up period, Long bone fractures, Pain management, Postoperative analgesia, Tertiary care hospital

Abstract

Background: Musculoskeletal trauma represents a considerable global health burden. Pain is a complex, subjective personal experience. The assessment of pain is the essential perquisite for successful pain management. It is useful to decide the plan of initial treatment but also to reassess the degree of success. So the purpose of the study was to do assessment of pain management intervention, post-op analgesics for treatment of long bone fractures.

Methods: All adult patients (more than IS years) reporting to Emergency Medicine Department of a tertiary care hospital with long hone fractures of lower limb were included in the study. Patient pain management was assessed by visual analogue score (VAS). Pain is a complex, subjective personal experience. The assessment of pain is the essential perquisite for successful pain management. It is useful to decide the plan of initial treatment but also to reassess the degree of success. The entire data is statistically analyzed using SPSS software. p-values less than 0.05 are considered to be statistically significant.

Results:  74 cases got operated, 64 cases (86.5.0%) did not have any intra-op complications and 10 cases (13.50%) had intra-op complications .Postoperative analgesia the 74 cases operated was as follows: 17 cases (23.0%) epidural anaesthesia 41 Cases (55.4%) had epidural + intravenous analgesics. Recent was managed with 1.V, analgesics alone; 12 cases (16.20%) had tramadol, 2 cases (2.7%) received paracetamol and 2 cases (2.7%) had dynaper for post-operative analgesia.

Conclusion: Adequate pain management on arrival in the Emergency Department is an important aspect in patient care and is not at all difficult to achieve. Femoral nerve block in Proximal lower limb fractures is very effective and easy to perform.

References

Nejati A, Teymourian H, Behrooz L, Mohseni G. Pain management via Ultrasound-guided Nerve Block in Emergency Department; a Case Series Study. Emergency. 2017;5(1).

Minick P, Clark PC, Dalton JA, Horne E, Greene D, Brown M. Long-bone fracture pain management in the emergency department. J Emerg Nursing. 2012 May 31;38(3):211-7.

Heilman JA, Tanski M, Burns B, Lin A, Ma J. Decreasing Time to Pain Relief for Emergency Department Patients with Extremity Fractures. BMJ quality improvement reports. 2016 Dec 1;5(1):u209522-w7251.

Borchgrevink PC, Allen SM, Rosseland LA, Romundstad L, Breivik C. Kvarstein G, et al. Assessment of pain. BJA: British J Lais Hesia. 2008 Jul 1;101(1):17-24.

Bernard Rosner. Fundamentals of Biostatistics, 5th ed. Duxbury: 2000;80-240.

Robert H Riffenburg. Statistics in Medicine, 2nd ed. Academic press; 2005:85-125.

Sunder Rao P, Richard J. An Introduction to Biostatistics. A manual for students in health sciences. 4th ed. New Delhi: Prentice hall of India; 2006;86-160.

Orosz GM, Magaziner J, Hannan EL, Morrison RS, Koval K, Gilbert M, et al. Association of timing of surgery for hip fracture and patient outcomes. JAMA. 2004 Apr 14;291(14):1738-43.

Chung CH. Clinical audit in emergency medicine. Hong Kong J Emerge Med. 2003 Jul;10(3):181-7.

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Published

2019-09-23

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Section

Original Research Articles