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Analgesia of acute abdominal pain in the Emergency Department

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Panteleimon Kalaronis, Antonia Kalogianni, Martha Kelesi, Eytichia Evagelidou, Ioulia-Maria Mpalla, Amalia Karanasou, Christina Marvaki
Panteleimon Kalaronis, Antonia Kalogianni, Martha Kelesi, Eytichia Evagelidou, Ioulia-Maria Mpalla, Amalia Karanasou, Christina Marvaki

Abstract


Introduction: Pain accounts for 40% of all patients admitted to the Emergency Department (ED). The most common cause of pain is abdominal pain, which accounts for 8%. In contrast to the international guidelines, pain is under-treated making the phenomenon of oligoanalgesia apparent.

Aim: The purpose of this study was to explore the incidence of analgesia in patients admitted to the ED suffering from acute abdominal pain.  

Material and Method: This is a descriptive cross-sectional study. The studied sample consisted of 197 patients, who admitted to the ED of a General Hospital of Athens, Greece with reported symptom: acute abdominal pain. For data collection, a special designed form of closed-type questionnaires was used. Data analysis was performed by using the Statistic Package for Social Sciences (SPSS) statistical packet ver.19.

Results: Out of the total number of patients admitted to ED with reported abdominal pain, 74.6% received analgesia and the mean time of analgesia administration during ED admission was 46.43 minutes. The mean pain intensity at the first time point measurement was 7.16 and at the second one was 4.04, according to pain recording scale (0-10 scale). Non-opioid anti-inflammatories (52.3%),  non-steroidal analgesics (22.8%) and opioids (9.1%) were mainly administered patients during their ED stay

Conclusions: Despite the published international guidelines which refer to analgesia time and type, pain and especially abdominal pain, is under-treated. The key to tackling oligoanalgesia is to educate health professionals.


Keywords


Pain; acute abdominal pain; emergency department; oligoanalgesia

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References


Wilson JE, Pendleton JM. Oligoanagelsia in the Emergency Department. American Journal of Emergency Medicine. 1989; 7(6): p. 620-623.

International Association for the Study of Pain. [Online]. Available from: https://www.iasp-pain.org/.

Williams ACdC, Craig KD. Updating the definition of pain. 2016 November; 157(11): p. 2420-2423.

Calil A, Pimenta CA, Birolini D. The "Oligoanalgesia problem" in the Emergency care. CLINICS. 2007; 62(5): p. 591-598.

Ferguson JD, Monroe J. Abdominal pain. In Cone DC, Brice JH, Delbridge TR, Myers JB. Emergency Medical Services: Clinical Practice and Systems Oversight. 2nd ed. West Sussex: WILEY; 2015. p. 144-150.

Knopp RK, Dries D. Analgesia in Acute Abdominal Pain: What's Next? Annals of Emergency Medicine. 2006 August; 48(2): p. 161-163.

Rupp T, Delaney KA. Inadequate analgesia in emergency medicine. Annals of Emergency Medicine. 2004 April; 43(4): p. 494-503.

Breivik H, Borchgrevink PC, Allen SM, Rosseland LA, Hals EK, Kvarstein G, et al. Assessment of pain. British Journal of Anaestesia. 2008 July; 101(1): p. 17-24.

Barletta JF, Erstad BL, Loew M, Keim SM. A prospective study of pain control in the emergency department. American journal of therapeutics. 2000 August; 7(4): p. 251-255.

Todd KH, Ducharme J, Choiniere M, Crandall CS, Fosnocht DE, Homel P, et al. Pain in the emergency department: results of the pain and emergency medicine initiative (PEMI) multicenter study. The journal of pain: official journal of the American Pain Society. 2007 June; 8(6): p. 460-466.

Cordell WH, Keene KK, Giles BK, Jones JB, Jones JH, Brizendine EJ. The high prevalence of pain in emergency medical care. The American journal of Emergency medicine. 2002 May; 20(3): p. 165-169.

Amprachim SE, Lepetsos P, Kourkouta L. Causes of acute pain undertreatment. Scientific Chronicles 2014;19(1): 43-49 (Article in Greek)

Papandreou C, Damigos D. Chronic pain management in the elderly. Medical Rostrum. 2008; 113: p. 36-42. (Article in Greek)

Mayumi T, Yoshida M, Tazuma S, Furukawa A, Nishii O, Shigematsu K, et al. The Practice Guidelines for Primary Care of Acute Abdomen 2015. Japan Radiological Society. 2016; 34: p. 80-115.

Powers RD, Guertler AT. Abdominal pain in the ED: stability and change over 20 years. The American Journal of Emergency Medicine. 1995 May; 13(3): p. 301-303.

France J, Smith S, Smith L. The College of Emergency Medicine. [Online].; 2014 [cited 2019 February. Available from: https://www.rcem.ac.uk/docs/College%20Guidelines/5w.%20Management%20of%20Pain%20in%20Adults%20(Revised%20December%202014).pdf.

World Health Organization. [Online].; 2019 [cited 2019 February. Available from: https://www.who.int/.

Sokoloff C, Daoust R, Panquet J, Chauny JM. Is adequate pain relief and time to analgesia associated with emergency department length of stay? A retrospective study. BMJ Journals. 2014.

Beveridge R, Clarke B, Janes L, Savage N, Thompson J, Dodd G, et al. Implementation Guidelines for The Canadian Emergency Department. 1998;: p. 1-32.

Grant PS. Analgesia delivery in the ED. The American Journal Of Emergency Medicine. 2006 November; 24(7): p. 806-809.

Vellisaris D, Karanikolas M, Pantzaris N, Kipourgos G, Bambalis V, Karanikola K, et al. Acute Abdominal Pain Assessment in the Emergency Department: The Experience of a Greek University Hospital. Journal of clinical medicine research. 2017 December; 9(12): p. 987-993.

Motov SM, Khan AN. Problems and barriers of pain management in the emergency department: Are we ever going to get better? Journal of Pain Research. 2009; 2: p. 5-11.

Zoltie N, Cust MP. Analgesia in the acute abdomen. Annals of the Royal College of Surgeons of England. 1986 July; 68(4): p. 209-210.

Stephen T, Silen W, Cheema F, Reisner A, Aman S, Goldstein JN, et al. Effects of morphine analgesia on diagnostic accuracy in emergency department patients with abdominal pain: a prospective, randomized trial. Journal of the American College of Surgeons. 2003 January; 196(1): p. 18-31.

Pace S, Burke TF. Intravenous morphine for early pain relief in patients with acute abdominal pain. Academic emergency medicine. 1996 December; 3(12): p. 1086-1092.

Graber MA, Ely JW, Clarke S, Kurtz S, Weir R. Informed Concent and General Surgeons. Attitudes Toward the Use of Pain Medication in the Acute Abdomen. Ameriacn Journal of Emergency Medicine. 1999 March; 17(1): p. 113-116.

Nalamachu S, Pergolizzi JV, Raffa RB, Taylor R. Acute Pain Management in the Emergency Department: Emphasis on NSAIDs. Emergency Medicine: Open Access. 2013 December; 4(1).

Forman JP, Rimm EB, Curhan GC. Frequency of analgesic use and risk of hypertension among men. Archives of internal medicine. 2007 February; 167(4): p. 394-399.

Pollack CV, Diercks DB, Thomas SH, Shapiro NI, Fanikos J, Mace SE, et al. Patient‐reported Outcomes from A National, Prospective, Observational Study of Emergency Department Acute Pain Management With an Intranasal Nonsteroidal Anti‐inflammatory Drug, Opioids, or Both. Academic Emergency Medicine. 2016 March; 23(3): p. 331-341.

Zimmerman O, Halpern P. Opinion survey of analgesia for abdominal pain in Israeli emergency departments. The Israel Association Medical journal. 2004 November; 6(11): p. 681-685.


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