Acute Pain Management in ER

According to” International Association for the study of Pain”(IASP), pain is defined as “An unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage.”

Pain can be acute or chronic. Continued inadequate treatment of acute Pain may itself lead to chronic pain.

Pain is declared as a “Fifth vital Sign” by Joint Commission on Accreditation of Healthcare Organization, in 1999.

In this present Era, our objective is to move forward towards a concept of achieving, “PAIN-FREE” ER This can be achieved by implementing and evolving concepts like Regional analgesia, Multimodal analgesia and Pre-emptive analgesia, thereby minimizing chronic pain at the doorstep.

Multimodal analgesia Which is defined as the use of two or more analgesic agents with a different mechanism of action in optimal dosages, to maximize efficacy and minimize the side effects from the use of individual agents(especially OPIOIDS).

It is believed that agents with different mechanisms of action have synergistic effects in preventing or treating acute Pain.

Pre-emptive analgesia defined as treatment that is initiated before surgery (as in most polytrauma/ traumas with hemodynamic instability, where ER, will be preoperative room) to prevent the establishment of peripheral and central sensitization, evoked by incisions and inflammatory injuries, occurring during surgery and in immediate postoperative period…

It has a protective effect on the nociceptive system that can reduce the immediate postoperative Pain as well as prevent the development of chronic pain by decreasing the altered sensory process…