Acute pain management in the Emergency Department: Use of multimodal and non-opioid analgesic treatment strategies

Am J Emerg Med. 2022 Aug:58:57-65. doi: 10.1016/j.ajem.2022.05.022. Epub 2022 May 22.

Abstract

Pain is a common complaint precipitating emergency department (ED) visit, occurring in more than half of patient encounters. While opioids are effective for acute pain management in the Emergency Department (ED), the associated adverse effects, including respiratory and central nervous system depression, nausea, vomiting, and constipation, and physical manifestations of use, including tolerance, dependence and misuse leading to overdose and death, accentuate the need for non-opioid alternatives and/or multi-modal pain control. This review will provide examples of non-opioid pain management strategies and multimodal regimens for treatment of acute pain in the ED.

Keywords: Acetaminophen; Acute pain; Dopamine receptor antagonists; Droperidol; Emergency department; Gabapentin; Haloperidol; Ketamine; Lidocaine; Multimodal pain control; Non-steroidal anti-inflammatory drugs; Nonpharmacologic; Opioids; Pregabalin.

Publication types

  • Review

MeSH terms

  • Acute Pain* / drug therapy
  • Analgesics, Non-Narcotic* / therapeutic use
  • Analgesics, Opioid
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Emergency Service, Hospital
  • Humans
  • Pain Management

Substances

  • Analgesics, Non-Narcotic
  • Analgesics, Opioid
  • Anti-Inflammatory Agents, Non-Steroidal