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Emerg Med Pract. 2019 Nov;21(11):1-24. Epub 2019 Nov 1.

Emergency department pain management: beyond opioids.

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Assistant Professor, Department of Emergency Medicine, King Saud University, Riyadh, Saudi Arabia.
Associate Clinical Professor, Department of Anesthesiology, Division of Critical Care and Department of Emergency Medicine University of California-San Diego, San Diego, CA.


Pain is a common factor in many emergency department visits. While opioids remain a mainstay of treatment for many patients, prescription-opioid overuse and misuse have become epidemic in the United States. A lack of clear understanding of the pain management options available contributes to this problem, resulting in opioid overuse and over-prescription. National guidelines and consensus statements emphasize the importance of knowing nonopioid pharmacological and nonpharmacological options for treating patients with acute pain. This evidence-based review summarizes the pathophysiology of pain and pain syndromes and provides recommendations for a variety of nonopioid treatment options.


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