Pain Management in the Unstable Trauma Patient

Purpose of Review: Review the current literature regarding the optimal approach to pain control in unstable trauma patients, specifically focusing on the initial management of pain and rapid transition to multi-modal agents. Recent Findings: There is a clear benefit to multi-modal analgesia instituted as rapidly as possible in trauma patients. While early management of pain depends upon the use of short-acting IV opioids, the rapid transition to adjunctive pain control strategies is optimal. The benefits include not only improved patient experience but also improved physiologic parameters and lower long-term risk of chronic pain and disability. Summary: The initial management of pain in unstable trauma patients is focused on titrating short-acting IV opioids to effect. Rapid institutions of multi-modal pain control, however, can improve short-term pain management while reducing the physiologic load imposed by uncontrolled pain and reduce the risk of long-term chronic pain and opioid misuse.