Volume 12, Issue 4 (12-2024)
J Surg Trauma 2024, 12(4): 151-155 |
Back to browse issues page
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Anvari M, MohammadKarimi N, Raee A, Afshari M, Jafari M, Dehghan F. Does Morphine Administration Consequences Missing of Spinal Fracture Patients in the Emergency Ward?. J Surg Trauma 2024; 12 (4) :151-155
URL: http://jsurgery.bums.ac.ir/article-1-448-en.html
URL: http://jsurgery.bums.ac.ir/article-1-448-en.html
Does Morphine Administration Consequences Missing of Spinal Fracture Patients in the Emergency Ward?
Motahare Anvari 
, Naser MohammadKarimi 
, Ali Raee , Mehdi Afshari , Mohamadali Jafari * , Farzaneh Dehghan
, Naser MohammadKarimi , Ali Raee , Mehdi Afshari , Mohamadali Jafari * , Farzaneh Dehghan
Department of Emergency Medicine, School of Medicine, Shahid sadoughi University of Medical Sciences, Yazd, Iran
Abstract: (558 Views)
Introduction: Studies have shown that factors that distract the patient from pain, such as more pain in other parts of the body or the use of analgesics, can impair the process of fracture diagnosis by reducing the patient's sensitivity to the presence of tenderness during the doctor's examination. This study investigated the effect of using analgesics as a distracting item in patients with traumatic cervical pain and tenderness and determined whether prescribing and administering analgesics to these patients caused patients with noticeable bone lesions to be examined less accurately. It also explored whether the correct administration of analgesics reduces the use of radiography.
Methods: A total of 62 trauma patients with midline cervical pain who met at least one criterion for cervical CT scan imaging and required analgesics as diagnosed by the physician were included in this cross-sectional study. First, the patients' pain scores were measured and recorded according to the Visual Analogue Scale (VAS) during the spinal examination. Subsequently, morphine at a dose of 0.05 mg/kg was administered intravenously. The pain scores of the patients were then recorded during the spinal examination at baseline and 30 minutes after administration. Subsequently, the patients were subjected to a CT scan of the cervical vertebrae, and the relationship between the pain score of the patients and the results of the CT scan was investigated.
Results: The mean pain score significantly decreased in patients with a normal condition (Not Presence of Fracture) after injection (P=0.004), but this difference was not significant in patients with a fractured spine, indicating that there was no improvement in pain with the administration of morphine in patients with serious cervical injuries (P=1.000).
Conclusion: In patients with cervical spine fractures, the administration of morphine did not completely alleviate the pain.
Methods: A total of 62 trauma patients with midline cervical pain who met at least one criterion for cervical CT scan imaging and required analgesics as diagnosed by the physician were included in this cross-sectional study. First, the patients' pain scores were measured and recorded according to the Visual Analogue Scale (VAS) during the spinal examination. Subsequently, morphine at a dose of 0.05 mg/kg was administered intravenously. The pain scores of the patients were then recorded during the spinal examination at baseline and 30 minutes after administration. Subsequently, the patients were subjected to a CT scan of the cervical vertebrae, and the relationship between the pain score of the patients and the results of the CT scan was investigated.
Results: The mean pain score significantly decreased in patients with a normal condition (Not Presence of Fracture) after injection (P=0.004), but this difference was not significant in patients with a fractured spine, indicating that there was no improvement in pain with the administration of morphine in patients with serious cervical injuries (P=1.000).
Conclusion: In patients with cervical spine fractures, the administration of morphine did not completely alleviate the pain.
Type of Study: Short Communication |
Subject:
Trauma
Received: 2024/08/3 | Accepted: 2024/12/23 | ePublished ahead of print: 2024/12/26 | Published: 2024/12/30
Received: 2024/08/3 | Accepted: 2024/12/23 | ePublished ahead of print: 2024/12/26 | Published: 2024/12/30
References
1. Dodds N, Hollis S, Islam M, Thompson J. Anatomical injury patterns, demographics and outcomes data for blunt and penetrating neck injuries on the trauma audit and research network database. Bulletin Royal College of Surgeons of England. 2023;105(2):70-75. [DOI:10.1308/rcsbull.2023.27]
2. Beeharry MW, Moqeem K, Rohilla MU. Management of cervical spine fractures: a literature review. Cureus. 2021;13(4): e14418. [DOI:10.7759/cureus.14418]
3. Cao S. Anesthesia for oral maxillofacial and neck trauma. Anesthesia for Oral and Maxillofacial Surgery: Springer; 2023:177-187. [DOI:10.1007/978-981-19-7287-4_13]
4. Abdoli A, Ghahramani S, Seif-Rabiei MA, Salimi R, Heshmati B. Comparison of the effect of ketorolac and morphine on pain management in patients with spinal trauma in emergency department: a randomized controlled clinical trial study. J Isfahan Med School. 2019;37(528):556-563.
5. Go JL, Acharya J, Branchcomb JC, Rajamohan AG. Traumatic neck and skull base injuries. Radiographics. 2019;39(6):1796-1807. [DOI:10.1148/rg.2019190177]
6. Paykin G, O'Reilly G, Ackland HM, Mitra B. The NEXUS criteria are insufficient to exclude cervical spine fractures in older blunt trauma patients. Injury. 2017;48(5):1020-1024. [DOI:10.1016/j.injury.2017.02.013]
7. Balakrishnan B, VanDongen-Trimmer H, Kim I, Hanson SJ, Zhang L, Simpson PM, et al. GCS-pupil score has a stronger association with mortality and poor functional outcome than GCS alone in pediatric severe traumatic brain injury. Pediatric Neurosurg. 2021;56(5):432-439. [DOI:10.1159/000517330]
8. Bielewicz J, Daniluk B, Kamieniak P. VAS and NRS, same or different? Are visual analog scale values and numerical rating scale equally viable tools for assessing patients after microdiscectomy? Pain Res Manag. 2022;2022(1):5337483. [DOI:10.1155/2022/5337483]
9. Wang J, Li Z, Tu Y, Gao F. The dopaminergic system in the ventral tegmental area contributes to morphine analgesia and tolerance. Neuroscience. 2023;527:74-83. [DOI:10.1016/j.neuroscience.2023.05.026]
10. Ahmadi K, Hashemian AM, Pishbin E, Sharif-Alhoseini M, Rahimi-Movaghar V. Impact of intravenous acetaminophen therapy on the necessity of cervical spine imaging in patients with cervical spine trauma. Chin J Traumatol. 2014;17(04):204-207.
11. Farsi D, Movahedi M, Hafezimoghadam P, Abbasi S, Shahlaee A, Rahimi Movaghar V. Acute pain management with intravenous 0.10 mg/kg vs. 0.15 mg/kg morphine sulfate in limb traumatized patients: a randomized double-blinded placebo-controlled trial. Ulus Travma Acil Cerrahi Derg. 2013;19(5):398-404. [DOI:10.5505/tjtes.2013.86383]
12. Sharifi MD, Doloo HZ, Hashemian AM, Tourghabe JT, Kakhki BR, Teimoori SJ, et al. Impact of morphine use in reducing the need for CT scan in patients with cervical spine trauma: a double blinded randomized clinical trial. Electron Physician. 2016;8(5):2432-2435. [DOI:10.19082/2432]
13. Liang Z, Thomas L, Jull G, Treleaven J. Cervical musculoskeletal impairments in migraine. Arch Physiother. 2021;11:27. [DOI:10.1186/s40945-021-00123-0]
14. Qiu XH, Yang XY, Wang YY, Tian SL, Yan YB, Xu AP, et al. Myofascial acupuncture versus routine acupuncture for mechanical neck pain: a protocol for a multicentre randomised controlled trial. BMJ Open. 2023;13(8):e068129. [DOI:10.1136/bmjopen-2022-068129]
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
Attribution-NoneCommercial CC BY-NC
