ANALGESIC MANAGEMENT IN PATIENTS WITH LIMB FRACTURES

Abstract

Introduction: pain resulting from a fracture is difficult to control and requires analgesic intervention as well as the immobilization of the limb. There is not available in the current literature a study that compare the intensity of pain perceived by patients with different types of fractures, not specifying what type of initial management should be performed for patients with limb fractures according to the type of fracture. Objective: to determine the effectiveness of initial analgesic management made in patients diagnosed with limb fractures, and to determine if there is a relation among pain perceived by the patient, the type of fracture and the analgesic response. Material and methods: observational, descriptive and prospective study was carried out to analyze patients diagnosed with limb fractures treated at the E.S.E. Hospital Universitario del Caribe between May and June in 2014. Patients were excluded if they had more than 24 hours after onset of fracture, previous use to the attention of analgesics or psychoactive substances, altered state of consciousness, history of neuromuscular disease or chronic analgesic treatment. The AO-ASIF classification of fractures was used to determine the location and type of fracture, and the verbal scale was used to check their pain intensity on admission and an hour after analgesia. The effectiveness of analgesia was determined if the pain was reduced in 50% or more since admission. Results: in the study participated 88 patients, 21 patients were excluded by the criteria, a total of 67 patients were identified to be analyzed. Significant differences were identified in perception of pain in all groups, according to the verbal pain scale of observation, median income higher pain was found and there was a decreased 1 hour after application of the initial analgesic management; however, only in 54.7% of patients the intervention was considered effective. No statistically significant difference was found between perceived pain and fractured bone segment, but it was difference comparing pain intensity according to the complexity of the fracture, with a higher degree of pain in cases of strokes high complexity. Conclusions: no significant differences were found in pain as the location of the fracture and the bone segments, however there is a difference in the complexity of the fracture line, this is directly related to the energy that causes the fracture, the magnitude of trauma and injury associated with soft tissue. Analgesics used for pain management in the sample of patients studied reduced significantly the pain, however, did not achieve adequate “effectiveness” in the initial management of pain in the different groups of limb fractures.Rev.cienc.biomed. 2015;6(2)290-297 KEYWORDS Pain management; Analgesics; Bone fractures.

Keywords

• Pain management; Analgesics; Bone fractures