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Management of Acute Musculoskeletal Pain

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Management of Acute Musculoskeletal Pain Review Article East African Orthopaedic Journal East African Orthopaedic Journal REFERENCES 14. Ekbäck, G., Axelsson, K., Ryttberg, L., et al. Tranexamic acid reduces blood loss in total hip replacement surgery. MANAGEMANAGEMENTMENT OF OF A ACUTECUTE M MUSCULOSKELETALUSCULOSKELETAL PAIN: PAIN: 1. Peden, M., McGee, K. and Sharma, G. The injury chart book: Anesth Analg 2000; 91: 1124–30. A REVIEW a graphical overview of the global burden of injuries. 15. Kauvar, D. S., Lefering, R. and Wade, C. E. Impact of Geneva: World Health Organization, 2002. hemorrhage on trauma outcome: an overview of A REVIEW 2. Gosselin, R. A, Spiegel, D. A, Coughlin, R., Zirkled, L. G. epidemiology, clinical presentations, and therapeutic J. M. Muthuuri, FCS (ECSA), MBChB, MMed (Surg), H.Dip.Orth (SA), Consultant Orthopaedic and Trauma Surgeon, considerations. J Trauma 2006; 60: S3–11. Injuries: the neglected burden in developing countries. J.The M. MombasaMuthuuri Hospital, FCS (ECSA), Private MBChB, Clinics, MMed P.O. Box(Surg), 84074, H.Dip.Orth Mombasa, (SA), Kenya. Consultant E-mail: Orthopaedic [email protected] and Trauma Surgeon, Bull World Health Organ 2009; 87: 246. 16. Mock, C. N., Jurkovich, G. J., nii-Amon-Kotei, D., Arreola- The Mombasa Hospital Private Clinics, P.O. Box 84074, Mombasa, Kenya. E-mail: [email protected] 3. Sauaia, A., Moore, F. A., Moore, E. E., et al. Epidemiology Risa, C. and Maier, R. V. Trauma mortality patterns in three of trauma deaths: a reassessment. J Trauma 1995; 38: nations at different economic levels: implications for ABSTRACT 185–93. global trauma system development. J Trauma 1998; 44: ABSTRACT 4. Lawson, J. H. and Murphy, M. P. Challenges for providing 804–12. Objectives: Acute musculoskeletal insult (injury and surgery) is very common. It is also one of the effective hemostasis in surgery and trauma. Sem Hematol 17. Wyatt, J., Beard, D., Gray, A., Busuttil, A. and Robertson, C. Objectives:commonest Acute sources musculoskeletal of acute pain. insult Unfortunately, (injury and surgery)this pain is is very also common.commonly It undertreated.is also one of theThis is The time of death after trauma. BMJ 1995; 310: 1502. 2004; 41: 55–64. commonestbecause of sources various of factors acute pain.that includeUnfortunately, poor understanding this pain is also of commonlythe subject, undertreated. fear of pharmacologic This is 5. Henry, D. A., Carless, P. A., Moxey, A. J., et al. Anti- 18. Fiechtner, B. K., Nuttall, G. A., Johnson, M. E., et al. Plasma agents, there uses and limitations. Untreated acute pain evolves to chronic pain which is more diffi- tranexamic acid concentrations during cardiopulmonary because of various factors that include poor understanding of the subject, fear of pharmacologic fibrinolytic use for minimising perioperative allogeneic cult to treat; and the result is the younger population of workers loose valuable time and the elderly bypass. Anesth Analg 2001; 92: 1131–36. agents, there uses and limitations. Untreated acute pain evolves to chronic pain which is more difficult blood transfusion. Cochrane Database Syst Rev 2007; 4: become more morbid and incapacitated. The purpose of this paper is to discuss the broad principles CD001886. 19. Horrow, J. C., Van Riper, D. F., Strong, M. D., Grunewald, to treat; and the result is the younger population of workers loose valuable time and the elderly K. E. and Parmet, J. L. The dose-response relationship of of multimodal and multi-agent approach to acute pain management for better patient care. 6. Okamoto, S., Hijikata-Okunomiya, A., Wanaka, K., Okada, become more morbid and incapacitated. The purpose of this paper is to discuss the broad principles Y. and Okamoto, U. Enzyme controlling medicines: tranexamic acid. Anesthesiology 1995; 82: 383–92. introduction. Semin Thromb Hemost 1997; 23: 493–501. 20. MRC CRASH Trial Collaborators. Predicting outcome after of Datamultimodal Source: and The multi-agent material source approach is from to various acute pain published management articles forin books better and patient journals. care. traumatic brain injury: practical prognostic models based 7. Coats, T., Roberts, I. and Shakur, H. Antifibrinolytic drugs Data Source: The material source is from various published articles in books and journals. for acute traumatic injury. Cochrane Database Syst Rev on large cohort of international patients. BMJ 2008; 12: Data Selection/Extraction: This is a review article on general principles. No specific data is given to 2004; 4: CD004896. 12. Datacompare Selection/ a method Extraction: or an This agent is awith review another. article on general principles. No specific data is given to 8. Baigent, C., Peto, R., Gray, R., Parish, S. and Collins, R. Large- 21. Maas, A. I., Steyerberg, E. W., Butcher, I., et al. Prognostic value of computerized tomography scan characteristics compare a method or an agent with another. scale randomized evidence: trials and meta-analyses of Conclusions: Control of acute musculoskeletal pain, whethertraumatic or postoperative is more like- trials. In: Warrell DA, Cox TM, Firth JD, eds. Oxford Textbook in traumatic brain injury: results from the IMPACT study. Conclusion: Control of acute musculoskeletal pain, whether traumatic or postoperative is more likely J. Neurotrauma 2007; 24: 303–14. ly to be achieved by use of modern protocols that apply existing basic techniques. Staff education of Medicine (5th edn). Oxford: Oxford University Press, to beand achieved regular assessmentby use of modern of pain protocols using formal that applyscoring existing systems basic is critical. techniques. Multimodal Staff education approach andshould 2010: 31–45. 22. Perel, P., Roberts, I., Bouamra, O., Woodford, M., Mooney, result into improved quality of care. Parenteral opioids administered by intramuscular injection or 9. Perel, P., Edwards, P., Shakur, H. and Roberts, I. Use of the J. and Lecky, F. Intracranial bleeding in patients with regular assessment of pain using formal scoring systems is critical. Multimodal approach should Oxford Handicap Scale at hospital discharge to predict traumatic brain injury: a prognostic study. BMC Emerg Med resultby patient-controlled into improved quality analgesia of care. devices Parenteral are opioidsthe recommended administered approach. by intramuscular Addition injection of perioperative or by 2009, 9: 15. Glasgow Outcome Scale at 6 months in patients with patient-controlleduse of non-steroidal analgesia anti-inflammatory devices are the drugs recommended enhances approach.pain control. Addition Use of ofcontinuous perioperative spinal use tech - traumatic brain injury. BMC Med Res Methodol 2008, 8: 23. Hogan, M. C., Foreman, K. J., Naghavi, M., et al. Maternal niques is a useful alternative in selected patients. Combinations of techniques are the most effective of non-steroidal anti-inflammatory drugs enhances pain control. Use of continuous spinal techniques 72. mortality for 181 countries, 1980-2008: a systematic with potential benefits in terms of overall patient outcome. 10. Duley, L., Antman, K., Arena, J., et al. Specific barriers to the analysis of progress towards Millennium Development is a useful alternative in selected patients. because the periosteum has a lower pain threshold conduct of randomized trials. Clin Trials 2008; 5: 40–48. Goal 5. Lancet 2010; 375: 1609–23. 24. Ferrer, P., Roberts, I., Sydenham, E., Blackhall, K. and Shakur, INTRODUCTIONCombinations of techniques are the most comparedmatory and to otherneoplastic deep somaticconditions structures in the (1). musculo Chronic- 11. Sterne, J., White, I., Carlin, J., et al. Multiple imputation skeletal tissues adds to this burden. for missing data in epidemiological and clinical research: H. Anti-fibrinolytic agents in postpartum haemorrhage: a effective with potential benefits in terms of pain from degenerative, inflammatory and neoplastic Pain is recognized as an undesirable sensory potential and pitfalls. BMJ 2009; 338: b2393. systematic review. BMC Pregnancy Childbirth 2009; 9: 29. Painoverall is an unpleasantpatient outcome. sensation or feeling caused by conditions in the musculoskeletal tissues adds to this 25. Shakur, H., Elbourne , D., Gülmezoglu, M., et al. The noxious stimuli with or without damage to the body. input, the experience which has affective and cog- 12. Rogers, A. and MacMahon, S. Systematic underestimation burden. of treatment effects as a result of diagnostic test WOMAN Trial (World Maternal Antifibrinolytic Trial): It remains a poorly understood, complex phenome- nitive repercussions.This perception is determined Pain is recognized as an undesirable sensory inaccuracy: implications for the interpretation and design tranexamic acid for the treatment of postpartum INTRODUCTIONnon that is controlled by neural, cellular, and humoral by factors such as age, gender, personality and previous of thromboprophylaxis trials. Thromb Haemost 1995; 73: haemorrhage: an international randomised, double blind mechanisms. lt has strong emotional and psychologic input,pain experiences. the experience which has affective and cognitive 167–71. Pain can be classified pathophysiological as placebo controlled trial. Trials 2010; 11: 40. Paincomponents is an unpleasant to it that requiresensation to beor addressedfeeling caused in order by repercussions. This perception is determined by factors 13. Brohi, K., Cohen, M. J., Ganter, M. T., et al. Acute nociceptive, neuropathic or mixed. Nociceptive noxiousto effectively stimuli controlwith or pain.without Acute
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