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J Korean Soc Emerg Med > Volume 27(6); 2016 > Article
Journal of The Korean Society of Emergency Medicine 2016;27(6): 602-617.
응급의학과 의사의 통증 조절 성향에 대한 분석
이강호1, 민문기1, 류지호1, 김용인1, 박맹렬1, 이대섭1, 염석란1, 한상균1, 정원준2
1부산대학교 의학전문대학원 응급의학교실
2충남대학교 의학전문대학원 응급의학교실
The Analysis about Tendency of Emergency Medicine in Pain Control
Kang Ho Lee1, Mun Ki Min1, Ji Ho Ryu1, Yong In Kim1, Maeng Real Park1, Daesup Lee1, Seok Ran Yeom1, Sang Kyun Han1, Won Jun Jeong2
1Department of Emergency Medicine, Pusan National University School of Medicine, Pusan, Korea
2Department of Emergency Medicine, Chungnam National University School of Medicine, Daejeon, Korea
Correspondence  Mun Ki Min ,Tel: 055-360-2143, Fax: 055-360-2173, Email: broadman@hanmail.net,
Received: May 16, 2016; Revised: May 17, 2016   Accepted: September 2, 2016.  Published online: December 31, 2016.
ABSTRACT
Purpose:
Inadequate treatment of pain, which has been termed as “oligoanalgesia”, appears to be common phenomenon the emergency department (ED). In order to improve pain recognition and management, a study concerning physician characteristics on pain and pain management is needed.
Method:
This study was based on a survey that targeted emergency medicine doctors from September to November 2015 (the response rate was 7%). Firstly, the survey showed that physicians preferred medicating on five diseases abdominal pain, cancer, simple musculoskeletal disease, trauma, headache in the ED. Secondly, it demonstrated the criteria used to choose the analgesic treatment in accordance with each disease and the level of pain, which is determined using a numerical rating scale (NRS).
Results:
In the cases of abdominal pain that requires surgery, cancer pain, and multiple trauma, physicians preferred using an opioid as the first medication, while non steroidal anti inflammatory drugs (NSAIDs) are prescribed in most of the other cases. Meperidine was the preferred choice as the opioid. For almost diseases, the NSAIDs are selected in the lower NRS cases over the opioid. Physicians deal with pain of patients who are already diagnosed with specific diseases, such as cancer, while they avoid managing pain from those patients who have not been definitively diagnosed with a specific disease.
Conclusion:
Physicians in the ED prefer the use of NSAIDs as the analgesic treatment, in particular, prescribing meperidine as the preferred opioid. However, it seems that they are hesitant to manage pain without a clear diagnosis.
Key words: Analgesics, Pain, Pain management, Opioid
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