Trauma pain management

US Department of Health and Human Services. Agency for Health Care Policy and Research. Acute Pain Management Operative or Medical Procedures and Trauma AHCPR Rockville, Maryland, 1993. 

Opioids remain the mainstay of pain treatment. Useful guidelines for their administration have been developed for a number of clinical situations, including treatment of acute pain, trauma, cancer, nonmalignant chronic pain, and pain in children. In the case of cancer pain, adherence to standardized protocols can improve pain management significantly. Guidelines for the oral and parenteral dosing of opioids are presented in Table 21-5. 

Sinatra RS, Ennevor S. Pain management following thoracic and upper abdominal trauma. In Rosenberg AD, ed. International Trauma Anesthesia and Critical Care Society. Baltimore, 1999. 

Fulda, G. J., Giberson, F., and Fagraeus, L. (2005), A prospective randomized trial of nebulized morphine compared with patient-controlled analgesia morphine in the management of acute thoracic pain, J. Trauma, 59, 383-388 discussion 389-390. 

The tooth pulp can become exposed by a variety of processes, including deep caries, trauma or accidentally during cavity preparation in the dental chair [60]. The consequences can be severe, and include pain, infection and necrosis. When the pulp is exposed, steps need to be taken to manage the situation, and these involve either pulp capping with an appropriate material [60,61] or removal of the pulp followed by sealing of the tooth roots. In the present section of the chapter, we consider briefly materials for the first of these options, pulp capping. 

Cumulative Trauma Disorders (CTDs) occur when stresses build up over time in a part of the body and cause pain or other discomfort. CTDs are often difficult to identity, classify, and manage because employees respond differently to stress, and they can be aggravated by activities outside the warehouse. Causes are sometimes difficult to isolate and control. 

---