Efficacy of fentanyl analgesia for trauma in critical care transport

• Published in: The American journal of emergency medicine 2006-05, Vol.24 (3), p.286-289
• Main Authors: Frakes, Michael A., Lord, Wendy R., Kociszewski, Christine, Wedel, Suzanne K.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Analgesia - methods; Analgesics, Opioid - therapeutic use; Analysis of Variance; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis; Child; Clinical death. Palliative care. Organ gift and preservation; Critical care; Critical Care - methods; Documentation; Emergency medical care; Female; Fentanyl - therapeutic use; Hospitals; Humans; Intensive care medicine; Male; Medical sciences; Middle Aged; Pain; Pain management; Pain Measurement; Patient satisfaction; Retrospective Studies; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Transportation of Patients
• ISSN: 0735-6757; 1532-8171
• DOI: 10.1016/j.ajem.2005.11.021

Pain relief is one of the most important interventions for out-of-hospital patient care providers. This paper documents the need for and benefits from the administration of fentanyl to trauma patients during critical care transport. We underwent a retrospective review of the transport charts of 100 trauma patients who received fentanyl analgesia during transport and who were able to use a numeric response scale to rate their pain from 0 to 10. Mean initial pain report was 7.6 ± 2.2 units, relieved to 3.7 ± 2.8 units by a mean total fentanyl dose of 1.6 ± 0.8 μg/kg ( P < .001). Neither initial pain level nor pain relief differed between male and female patients, but did differ between patients originating at the site of injury and those transferred between hospitals. Fentanyl dose correlated poorly with the magnitude of pain relief (r = 0.22), but a dose greater than 2 μg/kg provided more relief than lower doses (5.1 ± 2.1 vs 3.6 ± 2.4, P < .02). Fentanyl analgesia from these critical care transport teams provided significant pain relief to trauma patients. Pain reduction was greater for patients who received more than 2.0 μg/kg of fentanyl.