Does a history of psychoactive substances abuse play a role in the level of pain of the patient with severe trauma?

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 >48hours. 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 mobilization, 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 (1,014-6,163) 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: Consumidores de drogas; Dolor; Drug users; Multiple trauma; Pain; Traumatismo múltiple.