Nociceptive Views - Edition 14 - 2022

Introduction

Management of the acute pain of trauma

It is known that South Africa has a high trauma load presenting to the emergency department. Acute pain continues to be the most common complaint in trauma patients. Acute pain is defined as pain of short and limited duration, of identifiable cause and which acts as a protective mechanism. It is expected to subside with healing. Acute pain assessment, as well as management remains challenging. Studies have shown that management is not ideal. Underestimation of the patient’s level of pain and sub-optimal pain management often leads to a myriad of complications increasing morbidity and mortality. It is therefore essential to have adequate knowledge about the proper management of acute pain.

When the body speaks its mind: How trauma shapes the development and trajectory of chronic pain

When people experience trauma, it doesn’t just impact them in terms of their mental health, it can impact their body as well. Traumatic events from earlier in life have been associated with a two- to three-fold increase in the subsequent development of chronic widespread pain, and reports of abuse in childhood are associated with as much as a 97% increase in risk for chronic pain in adulthood.

Going beyond the pain threshold: Pain management in the ICU

The International Association for the Study of Pain (IASP) defines pain as an unpleasant sensory and emotional experience linked with existing or potential tissue damage or characterised in terms of such damage. Inadequately treated pain has been shown to contribute to unfavorable outcomes such as decreased patient satisfaction, weakened immunity, delayed wound healing, longer hospital stays, increased duration of mechanical ventilation, and higher hospital expenditure.

Muscle function, physical function, and health-related quality of life outcomes in critically ill survivors

Critical illness is defined as any acute, life-threatening condition requiring vital organ support or intensive monitoring in an intensive care unit (ICU). In the last twenty-five years, intensive care medicine has evolved dramatically in medical technological innovations, resulting in reduced mortality in critically ill patients. While the survival of critical illness has improved, the impact of critical illness on critically ill survivors extends beyond ICU discharge.