Gravity of injury and analgesia in patients who suffered traffic accidents

Abstract

Objective: Identifying the frequency and gravity of injuries in patients who suffered accidents in traffic and the analgesic drugs utilized. Methods: Retrospective study, with a sample of 200 medical records of patients admitted to the emergency services of a reference hospital for trauma care. The gravity of the injuries was characterized by anatomic gravity rates and the analgesic therapy was based on the World Health Organization's Analgesic Ladder. Results: The main findings pointed to injuries in limbs, head, face and outer surface as the most frequent, and, in 85% of the cases, gravity was equal or lower than 3; As for analgesia, it was verified that 46;6% of the patients received dipyrone and paracetamol. Among the opioids, meperidine was used in 10.4% of the cases. Conclusion: The gravity of most injuries was equal or lower to 3, indicating injuries of light, moderate and serious gravity, located especially in four body regions; regarding analgesia, dipyrone was shown to be the most commonly-used drug and a low use of opioids was verified. Keywords: Analgesia; Wounds and injuries; Pain RESUMOObjetivos: Identificar a freqüência e gravidade das lesões em acidentados de transporte e as drogas analgésicas utilizadas. Métodos: Estudo retrospectivo, com amostra de 200 prontuários de pacientes internados no pronto-socorro de um Hospital referência para o atendimento ao trauma. A gravidade das lesões foram caracterizadas por índices de gravidade anatômicos e a terapêutica analgésica com base na Escada Analgésica da Organização Mundial de Saúde. Resultados: Os principais achados apontaram as lesões em membros, cabeça, face e superfície externa como as mais freqüentes, e em 85% dos casos com gravidade menor ou igual que 3; quanto a analgesia verificou-se que 46,6% dos pacientes receberam dipirona e paracetamol , entre os opióides destacou-se a meperidina com 10,4%. Conclusão: A maioria das lesões foram de gravidade igual ou menor a 3, indicativo de lesões de gravidade leve, moderada e séria, localizadas principalmente em quatro regiões corpóreas; quanto à analgesia, a dipirona apareceu como a droga mais utilizada e constatou-se reduzido uso de opióides. Descritores: Analgesia; Ferimentos e lesões; Dor RESUMEN Objetivos: Identificar la frecuencia y gravedad de las lesiones en accidentados de tránsito y las drogas analgésicas utilizadas. Métodos: Se trata de un estudio retrospectivo, con muestra de 200 historias clínicas de pacientes internados en el servicio de emergencia de un Hospital de referencia para la atención al trauma. La gravedad de las lesiones fue caracterizada por índices de gravedad anatómicos y la terapéutica analgésica con base en la Escalera Analgésica de la Organización Mundial de la Salud. Resultados: Los principales hallazgos apuntaron las lesiones en miembros, cabeza, cara y superficie externa como las más frecuentes, y en un 85% de los casos con gravedad menor o igual a 3; en cuanto a la analgesia se verificó que el 46,6% de los pacientes recibieron dipirona y paracetamol, entre los op...

Acute and chronic pain: a narrative review of the literature

“…However, due to the activation of several neuronal pathways during a long period of time, the character of pain may change and the acute pain can become chronic (1,7,9,10) . Literature points out as the triggering factors of these problems: sub treatment of pain, its undervaluation, the reduced use of opioids, inadequate training of health professionals on pain and medication phenomena, erroneous beliefs and values regarding pain and analgesia, the difficulty to assess pain or no systematic evaluation (3,(13)(14) . Regarding the origin of acute pain, the majority of studies analyzes its effects in the postoperative period, which also involves inflammatory or infectious processes, followed by pain resulting from trauma and burns, the latter concentrated in two authors in the national scene (13,15) .…”

“…Literature points out as the triggering factors of these problems: sub treatment of pain, its undervaluation, the reduced use of opioids, inadequate training of health professionals on pain and medication phenomena, erroneous beliefs and values regarding pain and analgesia, the difficulty to assess pain or no systematic evaluation (3,(13)(14) . Regarding the origin of acute pain, the majority of studies analyzes its effects in the postoperative period, which also involves inflammatory or infectious processes, followed by pain resulting from trauma and burns, the latter concentrated in two authors in the national scene (13,15) . As for the use of scales for acute pain assessment, stand out the numerical scale (0 to 10), the visual analogue scale, the verbal descriptor scale (no pain/mild pain/moderate pain/severe pain/unbearable pain) and the body chart (16)(17) .…”