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

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.