Analgesia in the emergency department: why is it not administered? Kant J, Dombagolla M, Lai F, Hendarto A, Taylor DM. Emerg Med J. 2018 Oct 30. pii: emermed-2018-207629. doi: 10.1136/emermed-2018-207629. [Epub ahead of print]
Pain in the emergency department: results of the pain and emergency medicine initiative (PEMI) multicenter study. Todd KH, Ducharme J, Choiniere M, Crandall CS, Fosnocht DE, Homel P, Tanabe P; PEMI Study Group. J Pain. 2007 Jun;8(6):460-6. Epub 2007 Feb 15
Comparing the analgesic effect of intravenous paracetamol with morphine on patients with renal colic pain: A meta-analysis of randomized controlled studies. Zhili X, Linglong C, Shuang J, et al. Am J Emerg Med. 2020 Apr 2. pii: S0735-6757(20)30217-5. doi: 10.1016/j.ajem.2020.03.061. (Systematic review)
Conclusions: Intravenous paracetamol may result in lower pain scores at 30 min than morphine for renal colic pain, and more studies should be conducted to compare their analgesic efficacy.
Comparison of Oral Ibuprofen at Three Single-Dose Regimens for Treating Acute Pain in the Emergency Department: A Randomized Controlled Trial, Motov S, Masoudi A, Drapkin J, Sotomayor C, Kim S, Butt M, Likourezos A, Fassassi C, Hossain R, Brady J, Rothberger N, Flom P, Marshall J., Annals of Emergency Medicine 2019 August 2
CONCLUSION: Oral ibuprofen administered at doses of 400, 600, and 800 mg has similar analgesic efficacy for short-term pain relief in adult patients presenting to the ED with acute pain.
Cannabis et Canabinoïdes
Cannabinoids for Medical Use: A Systematic Review and Meta-analysis. Whiting PF, Wolff RF, Deshpande S, Di Nisio M, Duffy S, Hernandez AV, Keurentjes JC, Lang S, Misso K, Ryder S, Schmidlkofer S, Westwood M, Kleijnen J. JAMA. 2015 Jun 23-30;313(24):2456-73. doi: 10.1001/jama.2015.6358. Review. Erratum in: JAMA. 2016 Apr 12;315(14):1522. Erratum in: JAMA. 2015 Aug 4;314(5):520. JAMA. 2015 Aug 25;314(8):837. JAMA. 2015 Dec 1;314(21):2308.
The use of intranasal analgesia for acute pain control in the emergency department: A literature review, Billy Sin, Jennifer Wiafe, Christine Ciaramella, Luis Valdez, Sergey M Motov, American Journal of Emergency Medicine 2017 November 20
Conclusion: Eleven randomized controlled trials with various methodological flaws revealed conflicting conclusions. There is limited evidence to support the use of the IN analgesia over traditional routes for acute pain in the ED. The IN route may be a good alternative in scenarios where IV access is not feasible, patients are refusing injectable medications, or a fast onset of pain relief is needed.
Pharmacokinetics and pharmacodynamics of intranasal versus intravenous fentanyl in patients with pain after oral surgery. Foster D, Upton R, Christrup L, Popper L. Ann Pharmacother. 2008 Oct;42(10):1380-7. doi: 10.1345/aph.1L168. Epub 2008 Aug 26. PMID: 18728103.
Consensus Guidelines on the Use of Intravenous Ketamine Infusions for Chronic Pain From the American Society of Regional Anesthesia and Pain Medicine, the American Academy of Pain Medicine, and the American Society of Anesthesiologists, Reg Anesth Pain Med. 2018 Jul; 43(5): 521–546. Published online 2018 Jun 7. doi: 10.1097/AAP.0000000000000808
A Systematic Review and Meta-analysis of Ketamine as an Alternative to Opioids for Acute Pain in the Emergency Department. Karlow N, Schlaepfer CH, Stoll CRT, Doering M, Carpenter CR, Colditz GA, Motov S, Miller J, Schwarz ES. Acad Emerg Med. 2018 Oct;25(10):1086-1097. doi: 10.1111/acem.13502. Epub 2018 Jul 17. Review.
RESULTS: Three studies met the criteria for inclusion in this meta-analysis. Compared to pain scale reduction with morphine, ketamine was not inferior (relative reduction = 0.42, 95% confidence interval = -0.70 to 1.54). No severe adverse events were reported in any study, but higher rates of nonsevere adverse events were observed with ketamine.
Comparing the analgesic efficacy of morphine plus ketamine versus morphine plus placebo in patients with acute renal colic: A double-blinded randomized controlled trial, Am J Emerg Med. 2018 Sep 3. pii: S0735-6757(18)30733-2. doi: 10.1016/j.ajem.2018.09.004. [Epub ahead of print]
Pharmacotherapy for neuropathic pain in adults: systematic review, meta-analysis and updated NeuPSIG recommendations, Lancet Neurol. 2015 Feb; 14(2): 162–173. Published online 2015 Jan 7. doi: 10.1016/S1474-4422(14)70251-0
Are non-pharmacologic pain interventions effective at reducing pain in adult patients visiting the Emergency Department? A Systematic Review and Meta-analysis, Jeffrey T Sakamoto, Heather Burrell Ward, Joao Ricardo Nickenig Vissoci, Stephanie A Eucker, Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine 2018 March 15
Conclusion: Nonpharmacologic interventions are often effective in reducing pain in the ED. However, mostexisting studies are small, warranting further investigation into their use for optimizing ED pain management
Conclusions: Each refill and week of opioid prescription is associated with a large increase in opioid misuse among opioid naive patients.
Conclusions People receiving tramadol alone after surgery had similar to somewhat higher risks of prolonged opioid use compared with those receiving other short acting opioids. Federal governing bodies should consider reclassifying tramadol, and providers should use as much caution when prescribing tramadol in the setting of acute pain as for other short acting opioids.