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Inicio Enfermería Intensiva (English Edition) Does a history of psychoactive substances abuse play a role in the level of pain...
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Vol. 29. Issue 2.
Pages 64-71 (April - June 2018)
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Vol. 29. Issue 2.
Pages 64-71 (April - June 2018)
Original article
DOI: 10.1016/j.enfie.2017.08.002
Does a history of psychoactive substances abuse play a role in the level of pain of the patient with severe trauma?
¿Influyen los antecedentes de consumo de sustancias psicótropas en el nivel de dolor del paciente con traumatismo grave?
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C. López-López
Corresponding author
candelas.lopez@salud.madrid.org

Corresponding author.
, A. Arranz-Esteban, M.V. Martinez-Ureta, M.C. Sánchez-Rascón, C. Morales-Sánchez, M. Chico-Fernández
Servicio de Medicina Intensiva, UCI de Traumatismos y Emergencias, Hospital Universitario 12 de Octubre, Madrid, Spain
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Tables (4)
Table 1. General characteristics of the groups.
Table 2. Psychotropic substances consumed in group i.
Table 3. Analgesia and sedation.
Table 4. Mild pain and moderate-severe pain during mobilisation.
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Abstract
Objective

To analyse the influence of psychotropic substance use on the level of pain in patients with severe trauma.

Design

Longitudinal analytical study.

Scope

Intensive Care Unit (ICU) of Trauma and Emergencies.

Patients

Severe trauma, non-communicative and mechanical ventilation >48h. Two groups of patients were created: users and non-users of psychotropic substances according to medical records.

Interventions

Measurement of pain level at baseline and during mobilisation, using the Pain Indicator Behaviour Scale.

Variables

Demographic characteristics, pain score, sedation level and type and dose of analgesia and sedation.

Results

Sample of 84 patients, 42 in each group. The pain level in both groups, during mobilisation, showed significant differences p=0.011, with a mean of 3.11 (2.40) for the user group and 1.83 (2.14) for the non-user group. A relative risk of 2.5 CI (1014–6163) was found to have moderate/severe pain in the user group compared to the non-user group. The mean dose of analgesia and continuous sedation was significantly higher in the user group: p=.032 and p=.004 respectively. There was no difference in bolus dose of analgesia and sedation with p=.624 and p=.690 respectively.

Conclusions

Patients with a history of consumption of psychoactive substances show higher levels of pain and experience a higher risk of this being moderate/severe compared to non-users despite receiving higher doses of analgesia and sedation infusion. Key words: pain, multiple trauma, drug users.

Keywords:
Pain
Multiple trauma
Drug users
Resumen
Objetivo

Analizar la influencia del consumo de sustancias psicótropas en el nivel de dolor de los pacientes con traumatismo grave.

Diseño

Estudio analítico longitudinal.

Ámbito

Unidad de Cuidados Intensivos (UCI) de Traumatismos y Emergencias.

Pacientes

Traumatismo grave, no comunicativo y ventilación mecánica > 48 h. Se crearon 2 grupos de pacientes: consumidores de sustancias psicótropas y no consumidores según historia clínica.

Intervenciones

Medición del nivel de dolor en situación basal y durante la movilización, mediante la escala de conductas indicadoras de dolor.

Variables

Características demográficas, puntuación de dolor, nivel de sedación y tipo y dosis de analgesia y sedación.

Resultados

Muestra de 84 pacientes, correspondiendo 42 a cada grupo. El nivel de dolor en ambos grupos, durante la movilización, muestra diferencias significativas p=0,011, con una media de 3,11(2,40) para el grupo de consumidores y 1,83(2,14) para el grupo de no consumidores. Se objetiva un riesgo relativo (RR) de 2,5, IC (1,014–6,163) de tener dolor moderado/grave en el grupo de consumidores respecto al de no consumidores. La dosis media de analgesia y sedación continua es significativamente mayor en el grupo de consumidores: p=0,032 y p=0,004, respectivamente. No hay diferencia en la dosis de bolos de analgesia y sedación con p=0,624 y p=0,690, respectivamente.

Conclusiones

Los pacientes con antecedentes de consumo de sustancias psicótropas muestran mayor nivel de dolor y tienen más riesgo de que este sea moderado/grave respecto a los no consumidores, a pesar de recibir mayor dosis de analgesia y sedación continua.

Palabras clave:
Dolor
Traumatismo múltiple
Consumidores de drogas

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