Pain management for trauma

Neil Sinha, Steven Cohen

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Trauma remains a major cause of morbidity and mortality throughout the world. Medical advances have significantly reduced the mortality associated with trauma, which has led to an increased emphasis on secondary outcome measures, such as psychological well-being, functional improvement, and vocational and social reintegration. Pain has a profound impact on all of these variables. The stress response after multi-trauma exceeds that following elective surgery and includes cytokine and acute phase reactant release, altered immune response, and elevated levels of catecholamines, cortisol, growth hormone, and adrenocorticotropic hormone. Studies have shown that inadequately treated acute pain increases this response, which can result in higher morbidity (Yeager et al. 1987). Poorly controlled inflammatory pain also results in myriad anatomical and physiological changes in the nervous system (i.e., neuroplasticity), which can manifest as chronic neuropathic pain. Trauma patients with high levels of persistent pain are less likely to return to work, more likely to suffer from depression, posttraumatic stress disorder, and other psychological comorbidities, and report greater disability than trauma victims who report less pain (Jenewein et al. 2009, Yang et al. 2009). Even among survivors of severe trauma, the long-term mortality rate is significantly higher compared with matched controls, an effect that may be partly attributable to the sequelae of chronic pain (Naschitz and Lenger 2008).

Original languageEnglish (US)
Title of host publicationEssentials of Pain Management
PublisherSpringer New York
Pages401-415
Number of pages15
ISBN (Print)9780387875781
DOIs
StatePublished - 2011

Fingerprint

Pain Management
Wounds and Injuries
Pain
Chronic Pain
Mortality
Psychology
Morbidity
Neuronal Plasticity
Return to Work
Acute-Phase Proteins
Acute Pain
Neuralgia
Post-Traumatic Stress Disorders
Adrenocorticotropic Hormone
Nervous System
Growth Hormone
Catecholamines
Survivors
Hydrocortisone
Comorbidity

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Sinha, N., & Cohen, S. (2011). Pain management for trauma. In Essentials of Pain Management (pp. 401-415). Springer New York. https://doi.org/10.1007/978-0-387-87579-8_19

Pain management for trauma. / Sinha, Neil; Cohen, Steven.

Essentials of Pain Management. Springer New York, 2011. p. 401-415.

Research output: Chapter in Book/Report/Conference proceedingChapter

Sinha, N & Cohen, S 2011, Pain management for trauma. in Essentials of Pain Management. Springer New York, pp. 401-415. https://doi.org/10.1007/978-0-387-87579-8_19
Sinha N, Cohen S. Pain management for trauma. In Essentials of Pain Management. Springer New York. 2011. p. 401-415 https://doi.org/10.1007/978-0-387-87579-8_19
Sinha, Neil ; Cohen, Steven. / Pain management for trauma. Essentials of Pain Management. Springer New York, 2011. pp. 401-415
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