Effect of Rapid Administration Time to Analgesia on Adequate Pain Relief in the Emergency Department

ABSTRACT

PURPOSE: Patients presenting to an emergency department (ED) with pain related complaint continue to experience significant delay to analgesia. This study was conducted in order to evaluate the associations of adequate pain relief with analgesia and time to analgesia with ED length of stay. METHODS: This study was a retrospective analysis of real time data collected from the ED. We included all consecutive patients age 18 years and above with acute painful conditions during May 2013 to June 2013. We evaluated numerical rating scale (NRS) in patients with pain on admission to the ED and re-evaluated NRS at 30 minutes after analgesia administration. Adequate pain relief was defined as reduction of 50% or more of the initial pain score. RESULTS: A total of 560 patients met our inclusion criteria. Mean age was 44.7 years old and 52.7% were men; 13.6% of the patients were admitted with trauma. Among them, there were significant differences in terms of the proportion of male sex and NRS between those with time to analgesia within 30 minutes and beyond. In multivariate logistic analysis, trauma, higher initial NRS and time to analgesia within 30 minutes showed association with adequate pain relief (OR=2.77, 1.14 and 1.84 respectively). CONCLUSION: In our study, male and patients who had higher initial NRS showed association with rapid analgesia administration. In addition, trauma, higher initial NRS, single use of analgesia, chest pain and time to analgesia within 30 minutes showed association with adequate pain relief in the emergency department.