Acute Pain Management in Trauma Patients at a Tertiary Academic Hospital in the Gauteng Province: A Prospective Cross-Sectional Observational Study

Background: Ineffective management of acute pain in patients admitted following trauma or after a surgical procedure increases the risk of postoperative complications. This study investigated effectiveness of pharmacotherapy in the management of acute pain in patients admitted following trauma. Patients and Methods: This was a prospective observational study of patients admitted to our trauma unit. Data collected included demographic information, type of trauma, co-morbidities, history of use of addictive substances and depression and anxiety screening scores. Adequacy of pain control was assessed using the Numeric Rating Scale (NRS) was used to rate the severity of pain before and following administration of analgesic drugs. Statistical analysis included tests of associations between pain management adequacy and comorbidities. A p-value < 0.05 was deemed statistically significant. Results: The study included 143 participants of which 81.1% (116) were male, and 33.9% (48)) had penetrating injury. Paracetamol and/or Tramadol was prescribed to 78.6% (112) of the participants with severe pain. 62.9% (90) reported moderate to severe pain during treatment. Co-morbidities like HIV, diabetes mellitus and hypertension had no statistically significant influence on either pain scores before or during treatment (p > 0.05). Similarly, the influence the level of anxiety, depression scores or prior use of addictive substances on pain perception and effectiveness of analgesics was not statistically significant. Conclusion: Paracetamol and tramadol are the most frequently prescribed analgesic drugs for treatment of acute pain following trauma unit regardless of the mechanism of injury and severity of pain. Majority, 63% of the patients still experienced moderate to severe pain despite treatment. The mechanism of injury, co-morbid conditions, depression and anxiety levels, and history of drug abuse did not influence the intensity of pain perception and the effectiveness of analgesic drugs.