Improving trauma pain outcomes

PHILADELPHIA (November 13, 2019) – Improving acute pain management after traumatic injury remains a priority for policymakers and clinicians as rates of injury and subsequent pain-related disability rise nationally. Yet, innovations in trauma pain management remain understudied.

A 7-year prospective cohort study from the Corporal Michael J. Crescenz VA Medical Center (CMCVAMC), University of Pennsylvania School of Nursing (Penn Nursing), and the Perelman School of Medicine at the University of Pennsylvania examined the relationship between regional anesthesia (RA) administration and patient-reported pain-related outcomes among Operation Enduring Freedom and Operation Iraqi Freedom service members sustaining a combat-related extremity injury. The study, done in collaboration with the Department of Defense – Defense and Veterans Center for Integrative Pain Management (DVCIPM), found that when integrated into combat casualty care, early use of RA is associated with sustained pain benefits throughout rehabilitation and recovery.

“The improvements in average pain and pain relief in the first six months after injury observed in our study indicate a strong association between receiving early RA after combat injury in the austere battlefield environment and improved long-term pain outcomes,” said Penn Nursing’s Rosemary Polomano, PhD, RN, FAAN, Associate Dean for Practice, Professor of Pain Practice Penn Nursing, and co-investigator of the study. “These results suggest that effective, agile pain interventions initiated close to the time of injury can play an important role in reducing future pain.”

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The results of the study have been published in the journal Regional Anesthesia and Pain Medicine in an article titled “Prospective Cohort Study Examining the Use of Regional Anesthesia for Early Pain Management After Combat-related Extremity Injury.”

The principal investigator is Rollin M. Gallagher, MD, MPH, of the Center for Health Equity Research and Promotion, Corporal Michael J. Crescenz Veterans Affairs Medical Center in Philadelphia; and other co-investigators are Chester C. Buckenmaier, MD and Nicholas A. Giordano, PhD, RN, both of the DVCIPM, Department of Military and Emergency Medicine and Uniformed Services University; John T. Farrar, MD, PhD, Wensheng Guo, PhD, and Lynn Taylor, PhD, all of the Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania; David Oslin, MD, of the Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania ; and Brandon J. Goff, DO, of the Department of Rehabilitation Medicine, United States Army Brooke Army Medical Center.

The research was supported by a grant from the U.S. Department of Veterans Affairs (VARRD D45064-1).

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