Improving Emergency Medicine Patient Care
For Questions Or To Order, Call
800-249-5770
Mon-Fri 8am-5pm EST
View Full Site
Home Browse Articles CME Tests Login
Subscribe Visit Store View Cart

Home > Browse Emergency Issues

<< An Evidence-Based Approach To Traumatic Pain Management In The Emergency Department (Trauma CME)

References

Evidence-based medicine requires a critical appraisal of the literature based upon study methodology and number of subjects. Not all references are equally robust. The findings of a large, prospective, randomized, and blinded trial should carry more weight than a case report.

To help the reader judge the strength of each reference, pertinent information about the study will be included in bold type following the reference, where available. In addition, the most informative references cited in this paper, as determined by the authors, are noted by an asterisk (*) next to the number of the reference.

  1. Bonica J. Pain terms: a list with definitions and notes on usage. Recommended by the IASP Subcommittee on Taxonomy. Pain. 1979;6(3):247-248. (Consensus statement)
  2. Johnston CC, Gagnon AJ, Fullerton L, et al. One-week survey of pain intensity on admission to and discharge from the emergency department: a pilot study. J Emerg Med. 1998;16(3):377-382. (Survey; 286 patients)
  3. Stewart WF, Ricci JA, Chee E, et al. Lost productive time and cost due to common pain conditions in the US workforce. JAMA. 2003;290(18):2443-2454. (Cross-sectional survey; 23,902 responses)
  4. * Niska R, Bhuiya F, Xu J. National Hospital Ambulatory Medical Care Survey: 2007 emergency department summary. Natl Health Stat Report. 2010(26):1-31. (National health statistics)
  5. Beecher HK. Pain in men wounded in battle. Ann Surg. 1946;123(1):96-105. (Case series; 215 patients)
  6. Todd KH, Sloan EP, Chen C, et al. Survey of pain etiology, management practices and patient satisfaction in two urban emergency departments. CJEM. 2002;4(4):252-256. (Cross-sectional survey; 525 patients)
  7. Wilson JE, Pendleton JM. Oligoanalgesia in the emergency department. Am J Emerg Med. 1989;7(6):620-623. (Review; 198 patients)
  8. Dong L, Donaldson A, Metzger R, et al. Analgesic administration in the emergency department for children requiring hospitalization for long-bone fracture. Pediatr Emerg Care. 2012;28(2):109-114. (Retrospective; 773 patients)
  9. Lewis L, Lasater L, Brooks C. Are emergency physicians too stingy with analgesics? South Med J. 1994;87:7-9. (Retrospective; 401 patients)
  10. * Thomas S, ed. Emergency Department Analgesia. New York: Cambridge University Press; 2008. (Textbook)
  11. * Curtis L, Morrell T. Pain management in the emergency department. Emerg Med Pract. 2006;8(7):1-28. (Review)
  12. * Fink WA Jr. The pathophysiology of acute pain. Emerg Med Clin North Am. 2005;23(2):277-284. (Review)
  13. White LJ, Cooper JD, Chambers RM, et al. Prehospital use of analgesia for suspected extremity fractures. Prehosp Emerg Care. 2000;4(3):205-208. (Retrospective; 1073 patients)
  14. McEachin CC, McDermott JT, Swor R. Few emergency medical services patients with lower-extremity fractures receive prehospital analgesia. Prehosp Emerg Care. 2002;6(4):406-410. (Retrospective; 124 patients)
  15. Vassiliadis J, Hitos K, Hill CT. Factors influencing prehospital and emergency department analgesia administration to patients with femoral neck fractures. Emerg Med (Fremantle). 2002;14(3):261-266. (Retrospective; 176 patients)
  16. Swor R, McEachin CM, Seguin D, et al. Prehospital pain management in children suffering traumatic injury. Prehosp Emerg Care. 2005;9(1):40-43. (Retrospective, 109 patients)
  17. DeVellis P, Thomas SH, Wedel SK, et al. Prehospital fentanyl analgesia in air-transported pediatric trauma patients. Pediatr Emerg Care. 1998;14(5):321-323. (Retrospective; 131 patients)
  18. Kanowitz A, Dunn TM, Kanowitz EM, et al. Safety and effectiveness of fentanyl administration for prehospital pain management. Prehosp Emerg Care. 2006;10(1):1-7. (Retrospective; 2129 patients)
  19. DeVellis P, Thomas SH, Wedel SK. Prehospital and emergency department analgesia for air-transported patients with fractures. Prehosp Emerg Care. 1998;2(4):293-296. (Retrospective; 130 patients)
  20. Thomas SH, Rago O, Harrison T, et al. Fentanyl trauma analgesia use in air medical scene transports. J Emerg Med. 2005;29(2):179-187. (Prospective; 177 patients)
  21. Krauss WC, Shah S, Thomas SH. Fentanyl in the out-of-hospital setting: variables associated with hypotension and hypoxemia. J Emerg Med. 2011;40(2):182-187. (Prospective; 1055 patients)
  22. Galinski M, Dolveck F, Borron SW, et al. A randomized, double-blind study comparing morphine with fentanyl in prehospital analgesia. Am J Emerg Med. 2005;23(2):114-119. (Randomized, double-blind; 54 patients)
  23. Baskett PJ. Use of Entonox in the ambulance service. Br Med J. 1970;2(5700):41-43. (Retrospective; 66 patients)
  24. Amey BD, Ballinger JA, Harrison EE. Prehospital administration of nitrous oxide for control of pain. Ann Emerg Med. 1981;10(5):247-251. (Prospective; 88 patients)
  25. Johnson JC, Atherton GL. Effectiveness of nitrous oxide in a rural EMS system. J Emerg Med. 1991;9(1-2):45-53. (Retrospective; 200 patients)
  26. Hyland-McGuire P, Guly H. Effects on patient care of introducing prehospital intravenous nalbuphine hydrochloride. J Accid Emerg Med. 1998;15:99-101. (Prospective; 1000 patients)
  27. Houlihan KP, Mitchell RG, Flapan AD, et al. Excessive morphine requirements after pre-hospital nalbuphine analgesia. J Accid Emerg Med. 1999;16(1):29-31. (Case series; 10 patients)
  28. Porter K. Ketamine in prehospital care. Emerg Med J. 2004;21(3):351-354. (Case series; 32 patients)
  29. Jennings PA, Cameron P, Bernard S, et al. Morphine and ketamine is superior to morphine alone for out-of-hospital trauma analgesia: a randomized controlled trial. Ann Emerg Med. 2012;59(6):497-503. (Prospective randomized controlled; 135 patients)
  30. Barker R, Schiferer A, Gore C, et al. Femoral nerve blockade administered preclinically for pain relief in severe knee trauma is more feasible and effective than intravenous metamizole: a randomized controlled trial. J Trauma. 2008;64(6):1535-1538. (Prospective randomized; 52 patients)
  31. Lang T, Hager H, Funovits V, et al. Prehospital analgesia with acupressure at the Baihui and Hegu points in patients with radial fractures: a prospective, randomized, double-blind trial. Am J Emerg Med. 2007;25(8):887-893. (Prospective randomized double-blind placebo-controlled; 32 patients)
  32. Kober A, Scheck T, Greher M, et al. Prehospital analgesia with acupressure in victims of minor trauma: a prospective, randomized, double-blinded trial. Anesth Analg. 2002;95(3):723-727. (Prospective randomized double-blind placebo-controlled; 60 patients)
  33. Pointer JE, Harlan K. Impact of liberalization of protocols for the use of morphine sulfate in an urban emergency medical services system. Prehosp Emerg Care. 2005;9(4):377-381. (Retrospective; 64,340 patients)
  34. Fullerton-Gleason L, Crandall C, Sklar DP. Prehospital administration of morphine for isolated extremity injuries: a change in protocol reduces time to medication. Prehosp Emerg Care. 2002;6(4):411-416. (Prospective before/after; 963 patients)
  35. Gallagher RM. Physician variability in pain management: are the JCAHO standards enough? Pain Med. 2003;4(1):1-3. (Review)
  36. JCAHO. Standards, intents, examples and scoring questions for pain assessment and management- comprehensive accreditation manual for hospitals. Oakbrook Terrace, Illinois: JCAHO Department of Standards: Joint Commission for the Accreditation of Health Care Organizations 1999:1-11.
  37. Todd K, Samaroo N, Hoffman J. Ethnicity as a risk factor for inadequate emergency department analgesia. JAMA. 1993;269:1537-1539. (Retrospective; 139 patients)
  38. Todd KH, Deaton C, D’Adamo AP, et al. Ethnicity and analgesic practice. Ann Emerg Med. 2000;35(1):11-16. (Retrospective; 217 patients)
  39. Haslam L, Dale C, Knechtel L, et al. Pain descriptors for critically ill patients unable to self-report. J Adv Nurs. 2012;68(5):1082-1089. (Retrospective; 679 subjects)
  40. Tousignant-Laflamme Y, Rainville P, Marchand S. Establishing a link between heart rate and pain in healthy subjects: a gender effect. J Pain. 2005;6(6):341-347. (Observational; 39 volunteers)
  41. Thomas SH, Borczuk P, Shackelford J, et al. Patient and physician agreement on abdominal pain severity and need for opioid analgesia. Am J Emerg Med. 1999;17(6):586-590. (Prospective; 30 patients)
  42. Ducharme J, Barber C. A prospective blinded study on emergency pain assessment and therapy. J Emerg Med. 1995;13(4):571-575. (Prospective blinded cohort study; 384 patients)
  43. Tanabe P, Buschmann M. A prospective study of ED pain management practices and the patient’s perspective. J Emerg Nurs. 1999;25(3):171-177. (Prospective; 203 patients)
  44. Vazirani J, Knott JC. Mandatory pain scoring at triage reduces time to analgesia. Ann Emerg Med. 2012;59(2):134-138. (Prospective before/after; 35,628 patients)
  45. Thomas SH, Andruszkiewicz LM. Ongoing visual analog score display improves emergency department pain care. J Emerg Med. 2004;26(4):389-394. (Prospective randomized controlled; 300 patients)
  46. Bijur PE, Silver W, Gallagher EJ. Reliability of the visual analog scale for measurement of acute pain. Acad Emerg Med. 2001;8(12):1153-1157. (Prospective; 96 patients)
  47. Gallagher EJ, Bijur PE, Latimer C, et al. Reliability and validity of a visual analog scale for acute abdominal pain in the ED. Am J Emerg Med. 2002;20(4):287-290. (Prospective observational; 101 patients)
  48. Todd K, Funk K, Funk J, et al. Clinical significance of reported changes in pain severity. Ann Emerg Med. 1996;4:485-490. (Prospective; 48 patients)
  49. Gallagher E, Libman M, Bijur P. Prospective validation of clinically important changes in pain severity measured on a visual analog scale. Ann Emerg Med. 2001;38:633-638. (Prospective; 96 patients)
  50. Kelly A. Does the clinically significant difference in visual analog scale pain score vary with gender, age, or cause of pain? Acad Emerg Med. 1998;11:1086-1090. (Prospective; 152 patients)
  51. Fosnocht DE, Chapman CR, Swanson ER, et al. Correlation of change in visual analog scale with pain relief in the ED. Am J Emerg Med. 2005;23(1):55-59. (Prospective observational; 1490 patients)
  52. Bird S, Dickson E. Clinically significant changes in pain along the Visual Analog Scale. Ann Emerg Med. 2001;38:639-643. (Prospective; 77 patients)
  53. Silka P, Roth M, Moreno G. Pain scores improve analgesic administration patterns for trauma patients in the emergency department. Acad Emerg Med. 2004;11:264-270. (Prospective observational; 150 patients)
  54. Bijur P, Latimer C, Gallagher E. Validation of a verbally administered numerical rating scale of acute pain for use in the emergency department. Acad Emerg Med. 2003;10(4):390-392. (Prospective cohort; 108 patients)
  55. Berthier F, Potel G, Leconte P, et al. Comparative study of methods of measuring acute pain intensity in an ED. Am J Emerg Med. 1998;16(2):132-136. (Comparison; 290 patients)
  56. Kendrick DB, Strout TD. The minimum clinically significant difference in patient-assigned numeric scores for pain. Am J Emerg Med. 2005;23(7):828-832. (Prospective; 354 patients)
  57. Suraseranivongse S, Santawat U, Kraiprasit K, et al. Cross-validation of a composite pain scale for preschool children within 24 hours of surgery. Br J Anaesth. 2001;87(3):400-405. (Cross-validation; 167 pediatric patients)
  58. Merkel S, Voepel-Lewis T, Shayevitz J, et al. The FLACC: A behavioral scale for scoring postoperative pain in young children. Pediatr Nurs. 1997;23(3):293-297. (Observational; 89 children)
  59. McGrath PA, Seifert CE, Speechley KN, et al. A new analogue scale for assessing children’s pain: an initial validation study. Pain. 1996;64(3):435-443. (Comparison; 104 patients)
  60. Gélinas C, Johnston C. Pain assessment in the critically ill ventilated adult: validation of the Critical-Care Pain Observation Tool and physiologic indicators. Clin J Pain. 2007;23(6):497-505. (Prospective; 55 patients)
  61. Warden V, Hurley A, Volicer L. Development and psychometric evaluation of the Pain Assessment in Advanced Dementia (PAINAD) Scale. J Am Med Dir Assoc. 2003;4(1)4:9-15. (Prospective; 19 patients)
  62. Paulson-Conger M, Leske J, Maidl C, et al. Comparison of two pain assessment tools in nonverbal critical care patients. Pain Manag Nurs. 2011;12(4):218-224. (Prospective; 100 patients)
  63. Noble VE, Liteplo AS, Nelson BP, et al. The impact of analgesia on the diagnostic accuracy of the sonographic Murphy’s sign. Eur J Emerg Med. 2010;17(2):80-83. (Randomized double-blind placebo-controlled; 30 patients)
  64. * Thomas SH, Silen W, Cheema F, et al. Effects of morphine analgesia on diagnostic accuracy in emergency department patients with abdominal pain: a prospective, randomized trial. J Am Coll Surg. 2003;196(1):18-31. (Prospective randomized double-blind placebo-controlled; 74 patients)
  65. Gallagher EJ, Esses D, Lee C, et al. Randomized clinical trial of morphine in acute abdominal pain. Ann Emerg Med. 2006;48:150-160. (Prospective randomized double-blind placebo-controlled; 160 patients)
  66. Zacny JP, Lichtor JL, Binstock W, et al. Subjective, behavioral and physiological responses to intravenous meperidine in healthy volunteers. Psychopharmacology. (Berl). 1993;111(3):306-314. (Prospective randomized placebo-controlled crossover; 10 volunteers)
  67. * Nelson LS. Opioids. In: Hoffman RS, Goldfrank LR, Howland MA, Lewin NA, Flomenbaum NE, eds. Goldfrank’s Toxicologic Emergencies. 9th ed. New York: McGraw-Hill; 2011. (Textbook)
  68. Kurmis AP, Kurmis TP, O’Brien JX, et al. The effect of nonsteroidal anti-inflammatory drug administration on acute phase fracture-healing: a review. J Bone Joint Surg Am. 2012;94(9):815-823. (Review)
  69. Giannoudis PV, MacDonald DA, Matthews SJ, et al. Nonunion of the femoral diaphysis. The influence of reaming and non-steroidal anti-inflammatory drugs. J Bone Joint Surg Br. 2000;82(5):655-658. (Retrospective; 377 patients)
  70. 70. Bhattacharyya T, Levin R, Vrahas MS, et al. Nonsteroidal antiinflammatory drugs and nonunion of humeral shaft fractures. Arthritis Rheum. 2005;53(3):364-367. (Retrospective; 9995 patients)
  71. Hinz B, Cheremina O, Brune K. Acetaminophen (paracetamol) is a selective cyclooxygenase-2 inhibitor in man. FASEB J. 2008;22(2):383-390. (Clinical trial; 5 human volunteers)
  72. McGuinness SK, Wasiak J, Cleland H, et al. A systematic review of ketamine as an analgesic agent in adult burn injuries. Pain Med. 2011;12(10):1551-1558. (Systematic review)
  73. Strayer RJ, Nelson LS. Adverse events associated with ketamine for procedural sedation in adults. Am J Emerg Med. 2008;26(9):985-1028. (Systematic review)
  74. Bisanzo M, Nichols K, Hammerstedt H, et al. Nurse-administered ketamine sedation in an emergency department in rural Uganda. Ann Emerg Med. 2012;59(4):268-275. (Observational; 191 patients)
  75. Sehdev RS, Symmons DA, Kindl K. Ketamine for rapid sequence induction in patients with head injury in the emergency department. Emerg Med Australas. 2006;18(1):37-44. (Systematic review)
  76. Albanese J, Arnaud S, Rey M, et al. Ketamine decreases intracranial pressure and electroencephalographic activity in traumatic brain injury patients during propofol sedation. Anesthesiology. 1997;87(6):1328-1334. (Prospective; 8 patients)
  77. Schmidt A, Oye I, Akeson J. Racemic, S(+)- and R(-)-ketamine do not increase elevated intracranial pressure. Acta Anaesthesiol Scand. 2008;52(8):1124-1130. (Clinical trial; 9 pigs)
  78. Bar-Joseph G, Guilburd Y, Tamir A, et al. Effectiveness of ketamine in decreasing intracranial pressure in children with intracranial hypertension. J Neurosurg Pediatr. 2009;4(1):40-46. (Prospective controlled; 30 patients)
  79. Roberts DJ, Hall RI, Kramer AH, et al. Sedation for critically ill adults with severe traumatic brain injury: a systematic review of randomized controlled trials. Crit Care Med. 2011;39(12):2743-2751. (Systematic review; 380 patients)
  80. Bourgoin A, Albanese J, Wereszczynski N, et al. Safety of sedation with ketamine in severe head injury patients: comparison with sufentanil. Crit Care Med. 2003;31(3):711-717. (Prospective randomized double-blind; 25 patients)
  81. Bourgoin A, Albanese J, Leone M, et al. Effects of sufentanil or ketamine administered in target-controlled infusion on the cerebral hemodynamics of severely brain-injured patients. Crit Care Med. 2005;33(5):1109-1113. (Prospective randomized; 30 patients)
  82. Gerlach AT, Murphy CV, Dasta JF. An updated focused review of dexmedetomidine in adults. Ann Pharmacother. 2009;43(12):2064-2074. (Systematic review)
  83. Richards JR, Richards IN, Ozery G, et al. Droperidol analgesia for opioid-tolerant patients. J Emerg Med. 2011;41(4):389-396. (Review)
  84. Sharma SK, Davies MW. Patient-controlled analgesia with a mixture of morphine and droperidol. Br J Anaesth. 1993;71(3):435-436. (Prospective randomized; 50 patients)
  85. Lo Y, Chia YY, Liu K, et al. Morphine sparing with droperidol in patient-controlled analgesia. J Clin Anesth. 2005;17(4):271-275. (Randomized double-blind; 179 patients)
  86. Freedman GM, Kreitzer JM, Reuben SS, et al. Improving patient-controlled analgesia: adding droperidol to morphine sulfate to reduce nausea and vomiting and potentiate analgesia. Mt Sinai J Med. 1995;62(3):221-225. (Prospective randomized; 40 patients)
  87. Yamamoto S, Yamaguchi H, Sakaguchi M, et al. Preoperative droperidol improved postoperative pain relief in patients undergoing rotator-cuff repair during general anesthesia using intravenous morphine. J Clin Anesth. 2003;15(7):525-529. (Prospective randomized double-blind; 84 patients)
  88. Kao LW, Kirk MA, Evers SJ, et al. Droperidol, QT prolongation, and sudden death: what is the evidence? Ann Emerg Med. 2003;41(4):546-558. (Systematic review)
  89. Nuttall GA, Eckerman KM, Jacob KA, et al. Does low-dose droperidol administration increase the risk of drug-induced QT prolongation and torsade de pointes in the general surgical population? Anesthesiology. 2007;107(4):531-536. (Retrospective; 4528 patients)
  90. Schwartz NA, Turturro MA, Istvan DJ, et al. Patients’ perceptions of route of nonsteroidal anti-inflammatory drug administration and its effect on analgesia. Acad Emerg Med. 2000;7(8):857-861. (Randomized double-blinded; 64 patients)
  91. Dillion DC, Gibbs M. Local and Regional Anesthesia. In: Tintinalli JE KG, Stapczynski JS, ed. Tintinalli’s Emergency Medicine: A Comprehensive Study Guide, 7th ed. New York: McGraw-Hill; 2011. (Textbook)
  92. Massey T, Derry S, Moore RA, et al. Topical NSAIDs for acute pain in adults. Cochrane Database Syst Rev. 2010(6):CD007402. (Systematic review; 47 studies with 3455 patients)
  93. McGee HT, Fraunfelder FW. Toxicities of topical ophthalmic anesthetics. Expert Opin Drug Saf. 2007;6(6):637-640. (Review)
  94. Calder LA, Balasubramanian S, Fergusson D. Topical nonsteroidal anti-inflammatory drugs for corneal abrasions: meta-analysis of randomized trials. Acad Emerg Med. 2005;12(5):467-473. (Meta-analysis; 5 randomized controlled trials, 459 patients)
  95. Auroy Y, Benhamou D, Bargues L, et al. Major complications of regional anesthesia in France: The SOS Regional Anesthesia Hotline Service. Anesthesiology. 2002;97(5):1274-1280. (Prospective observational; 487 anesthesiologists)
  96. Bhoi S, Sinha TP, Rodha M, et al. Feasibility and safety of ultrasound-guided nerve block for management of limb injuries by emergency care physicians. J Emerg Trauma Shock. 2012;5(1):28-32. (Prospective; 50 patients)
  97. Noorily AD, Noorily SH, Otto RA. Cocaine, lidocaine, tetracaine: which is best for topical nasal anesthesia? Anesth Analg. 1995;81(4):724-727. (Prospective randomized; 8 volunteers)
  98. Campbell D, Adriani J. Absorption of local anesthetics. J Am Med Assoc. 1958;168(7):873-877. (Pharmacodynamic measurement; canine and human subjects)
  99. Nole R, Munson NM, Fulkerson JP. Bupivacaine and saline effects on articular cartilage. Arthroscopy. 1985;1(2):123-127. (Clinical trial, porcine and canine)
  100. Chu CR, Izzo NJ, Coyle CH, et al. The in vitro effects of bupivacaine on articular chondrocytes. J Bone Joint Surg Br. 2008;90(6):814-820. (In vitro clinical trial, human chondrocytes)
  101. Dragoo JL, Braun HJ, Kim HJ, et al. The in vitro chondrotoxicity of single-dose local anesthetics. Am J Sports Med. 2012;40(4):794-799. (In vitro clinical trial, human chondrocytes)
  102. Järvelä T, Järvelä S. Long-term effect of the use of a pain pump after arthroscopic subacromial decompression. Arthroscopy. 2008;24(12):1402-1406. (Prospective randomized; 50 patients)
  103. Chow MY, Sia AT, Koay CK, et al. Alkalinization of lidocaine does not hasten the onset of axillary brachial plexus block. Anesth Analg. 1998;86(3):566-568.
  104. Tetzlaff JE, Yoon HJ, Brems J, et al. Alkalinization of mepivacaine improves the quality of motor block associated with interscalene brachial plexus anesthesia for shoulder surgery. Reg Anesth. 1995;20(2):128-132. (Prospective randomized double-blind placebo-controlled; 40 patients)
  105. Hanna MN, Elhassan A, Veloso PM, et al. Efficacy of bicarbonate in decreasing pain on intradermal injection of local anesthetics: a meta-analysis. Reg Anesth Pain Med. 2009;34(2):122-125. (Meta-analysis; 1224 patients)
  106. Cooper DD, Seupaul RA. Does buffered lidocaine decrease the pain of local infiltration? Ann Emerg Med. 2012;59(4):281-282. (Meta-analysis; 1067 patients)
  107. Popping DM, Elia N, Marret E, et al. Clonidine as an adjuvant to local anesthetics for peripheral nerve and plexus blocks: a meta-analysis of randomized trials. Anesthesiology. 2009;111(2):406-415. (Meta-analysis; 1054 patients)
  108. Brummett CM, Williams BA. Additives to local anesthetics for peripheral nerve blockade. Int Anesthesiol Clin. 2011;49(4):104-116. (Review)
  109. Myderrizi N, Mema B. The hematoma block an effective alternative for fracture reduction in distal radius fractures. Med Arh. 2011;65(4):239-242. (Prospective randomized double-blind; 96 patients)
  110. Holmes CM. The history and development of intravenous regional anaesthesia. Acta Anaesthesiol Scand Suppl. 1969;36:11-18. (Review)
  111. Handoll HH, Madhok R, Dodds C. Anaesthesia for treating distal radial fracture in adults. Cochrane Database Syst Rev. 2010;11:11. (Systematic review)
  112. Heath ML. Deaths after intravenous regional anaesthesia. Br Med J (Clin Res Ed). 1982;285(6346):913-914. (Case series; 5 patients)
  113. Wakai A, Winter DC, Street JT, Redmond PH. Pneumatic tourniquets in extremity surgery. J Am Acad Orthop Surg. 2001;9(5):345-351. (Review)
  114. Candido KD, Pedicini EL, Winnie AP. Intravenous Regional Anesthesia. In: Reichman EF, Simon R, eds. Emergency Medicine Procedures. New York: McGraw-Hill; 2004. (Textbook)
  115. Hadzic A, Vloka J, Hadzic N, et al. Nerve stimulators used for peripheral nerve blocks vary in their electrical characteristics. Anesthesiology. 2003;98(4):969-974. (Observational; 15 nerve stimulators)
  116. Walker KJ, McGrattan K, Aas-Eng K, et al. Ultrasound guidance for peripheral nerve blockade. Cochrane Database Syst Rev. 2009(4):CD006459. (Systematic review)
  117. Wilhelmi BJ, Blackwell SJ, Miller JH, et al. Do not use epinephrine in digital blocks: myth or truth? Plast Reconstr Surg. 2001;107(2):393-397. (Prospective randomized double-blind; 60 patients)
  118. Chowdhry S, Seidenstricker L, Cooney DS, et al. Do not use epinephrine in digital blocks: myth or truth? Part II. A retrospective review of 1111 cases. Plast Reconstr Surg. 2010;126(6):2031-2034. (Retrospective; 1111 patients)
  119. Keramidas EG, Rodopoulou SG, Tsoutsos D, et al. Comparison of transthecal digital block and traditional digital block for anesthesia of the finger. Plast Reconstr Surg. 2004;114(5):1131-1134. (Prospective randomized double-blind; 50 patients)
  120. Hill RG, Jr, Patterson JW, Parker JC, et al. Comparison of transthecal digital block and traditional digital block for anesthesia of the finger. Ann Emerg Med. 1995;25(5):604-607. (Prospective randomized controlled blinded crossover; 31 patients)
  121. Cummings AJ, Tisol WB, Meyer LE. Modified transthecal digital block versus traditional digital block for anesthesia of the finger. J Hand Surg Am. 2004;29(1):44-48. (Prospective randomized double-blind crossover; 25 patients)
  122. Parker MJ, Griffiths R, Appadu B. Nerve blocks (subcostal, lateral cutaneous, femoral, triple, psoas) for hip fractures. Cochrane Database Syst Rev. 2010;4:4. (Systematic review)
  123. Winnie AP, Ramamurthy S, Durrani Z. The inguinal paravascular technic of lumbar plexus anesthesia: the “3-in-1 block.” Anesth Analg. 1973;52(6):989-996. (Prospective randomized; 20 patients)
  124. Blaivas M, Lyon M. Ultrasound-guided interscalene block for shoulder dislocation reduction in the ED. Am J Emerg Med. 2006;24(3):293-296. (Case series; 4 patients)
  125. Blaivas M, Adhikari S, Lander L. A prospective comparison of procedural sedation and ultrasound-guided interscalene nerve block for shoulder reduction in the emergency department. Acad Emerg Med. 2011;18(9):922-927. (Prospective randomized; 42 patients)
  126. Truitt MS, Murry J, Amos J, et al. Continuous intercostal nerve blockade for rib fractures: ready for primetime? J Trauma. 2011;71(6):1548-1552. (Prospective; 102 patients)
  127. Bulger EM, Edwards T, Klotz P, et al. Epidural analgesia improves outcome after multiple rib fractures. Surgery. 2004;136(2):426-430.
  128. Vreeland DL, Reader A, Beck M, et al. An evaluation of volumes and concentrations of lidocaine in human inferior alveolar nerve block. J Endod. 1989;15(1):6-12. (Prospective; 30 patients)
  129. Reichman EF, Kern KP. Dental Anesthesia and Analgesia. In: Reichman E, Simon R, eds, ed. Emergency Medicine Procedures. New York: McGraw-Hill; 2004. (Textbook)
  130. Lee H, Ernst E. Acupuncture analgesia during surgery: a systematic review. Pain. 2005;114(3):511-517. (Systematic review; 19 randomized controlled trials)
  131. Ernst E, Lee MS, Choi TY. Acupuncture: does it alleviate pain and are there serious risks? A review of reviews. Pain. 2011;152(4):755-764. (Review)
  132. Patterson DR, Jensen MP. Hypnosis and clinical pain. Psychol Bull. 2003;129(4):495-521. (Systematic review)
  133. Patterson DR, Jensen MP, Wiechman SA, et al. Virtual reality hypnosis for pain associated with recovery from physical trauma. Int J Clin Exp Hypn. 2010;58(3):288-300.
  134. Marco CA, Plewa MC, Buderer N, et al. Self-reported pain scores in the emergency department: lack of association with vital signs. Acad Emerg Med. 2006;13:974-979.
  135. Cope Z. Early Diagnosis of the Acute Abdomen. 1st ed. New York: Oxford University Press; 1921. (Textbook)
  136. LoVecchio F, Oster N, Sturmann K, et al. The use of analgesics in patients with acute abdominal pain. J Emerg Med. 1997;15(6):775-779. (Prospective randomized placebo-controlled; 48 patients)
  137. Pace S, Burke TF. Intravenous morphine for early pain relief in patients with acute abdominal pain. Acad Emerg Med. 1996;3(12):1086-1092. (Prospective double-blind placebo-controlled; 75 patients)
  138. Zoltie N, Cust MP. Analgesia in the acute abdomen. Ann R Coll Surg Engl. 1986;68(4):209-210. (Prospective double-blind placebo-controlled; 288 patients)
  139. Attard AR, Corlett MJ, Kidner NJ, et al. Safety of early pain relief for acute abdominal pain. BMJ. 1992;305(6853):554-556. (Prospective randomized placebo-controlled; 100 patients)
  140. * Manterola C, Vial M, Moraga J, et al. Analgesia in patients with acute abdominal pain. Cochrane Database Syst Rev. 2011(1):CD005660. (Systematic review)
  141. * Diercks DB, Mehrotra A, Nazarian DJ, et al. Clinical policy: critical issues in the evaluation of adult patients presenting to the emergency department with acute blunt abdominal trauma. Ann Emerg Med. 2011;57(4):387-404. (Clinical policy)
  142. Brown J, Klein E, Lewis C, et al. Emergency department analgesia for fracture pain. Ann Emerg Med. 2003;42:197-205. (Retrospective; 2828 patients)
  143. Selbst S, Clark M. Analgesia use in the emergency department. Ann Emerg Med. 1990;19:1010-1013. (Retrospective; 268 patients)
  144. Petrack EM, Christopher NC, Kriwinsky J. Pain management in the emergency department: patterns of analgesic utilization. Pediatrics. 1997;99(5):711-714. (Retrospective; 80 patients)
  145. Platts-Mills TF, Esserman DA, Brown DL, et al. Older US emergency department patients are less likely to receive pain medication than younger patients: results from a national survey. Ann Emerg Med. 2011. (Retrospective survey; 88,031 ED visits)
  146. Jones J, Johnson K, McNinch M. Age as a risk factor for inadequate emergency department analgesia. Am J Emerg Med. 1996;14:157-160. (Retrospective cohort; 231 patients)
  147. Duggleby W, Lander J. Cognitive status and post-operative pain: older adults. J Pain Symptom Manage. 1994;19:19-27. (Prospective; 60 patients)
  148. Morrison R, Magaziner J, Gilbert M. Relationship between pain and opioid analgesics on the development of delirium following hip fracture. J Gerontol. 2003;58:76-81. (Prospective; 541 patients)
  149. Hohl C, Dankoff J, Colacone A, et al. Polypharmacy, adverse drug-related events, and potential adverse drug interactions in elderly patients presenting to an emergency department. Ann Emerg Med. 2001;38:666-671. (Retrospective; 283 patients)
  150. Beyth R, Shorr R. Medication Use. In: Duthie E, Katz P, eds. Duthie: Practice of Geriatrics. 3rd ed. Philadelphia, PA: WB Saunders; 1998. (Textbook chapter)
  151. Griffin M, Yared A, Ray W. Nonsteroidal anti-inflammatory drugs and acute renal failure in elderly persons. Am J Epidemiol. 2000;151:488-496. (Retrospective case-control; 1799 patients)
  152. Buffum M, Buffum J. Nonsteroidal anti-inflammatory drugs in the elderly. Pain Management Nursing. 2000;1:40-50. (Review)
  153. Paulozzi LJ JC, Mack KA, Rudd RA. Vital signs: overdoses of prescription opioid pain relievers---United States, 1999-2008. MMWR. 2011;60(43):4187-1492. (Statistical report)
  154. Wide-ranging Online Data for Epidemiologic Research (WONDER). US Department of Health and Human Services, Centers for Disease Control and Prevention; 2010. Available at: http://wonder.cdc.gov/. Accessed September 30, 2011. (Online database)
  155. Perry S, Heidrich G. Management of pain during debridement: a survey of U.S. burn units. Pain. 1982;13(3):267-280. (Survey; 181 responses)
  156. Porter J, Jick H. Addiction rare in patients treated with narcotics. N Engl J Med. 1980;302(2):123. (Letter to the editor; 11,882 patients)
  157. * Hansen GR. The drug-seeking patient in the emergency room. Emerg Med Clin North Am. 2005;23(2):349-365. (Review)
  158. Tanabe P, Paice JA, Stancati J, et al. How do emergency department patients store and dispose of opioids after discharge? A pilot study. J Emerg Nurs. 2012;38(3):273-279. (Prospective; 25 patients)
  159. Inciardi JA, Surratt HL, Kurtz SP, et al. Mechanisms of prescription drug diversion among drug-involved club- and street-based populations. Pain Med. 2007;8(2):171-183. (Prospective interviews; 74 patients)
  160. Todd K. Focus on: treating chronic pain patients in the emergency department. ACEP News. 2008;27. Available at: http://www.acep.org/content.aspx?id=35352. Accessed April 12, 2012. (Review)
  161. * Rivara FP, Mackenzie EJ, Jurkovich GJ, et al. Prevalence of pain in patients 1 year after major trauma. Arch Surg. net2008;143(3):282-287. (Retrospective; 3047 patients)
  162. Beniczky S, Tajti J, Timea Varga E, et al. Evidence-based pharmacological treatment of neuropathic pain syndromes. J Neural Transm. 2005;112(6):735-749.
  163. Perez RS, Kwakkel G, Zuurmond WW, de Lange JJ. Treatment of reflex sympathetic dystrophy (CRPS type 1): a research synthesis of 21 randomized clinical trials. J Pain Symptom Manage. 2001;21(6):511-526. (Meta-analysis; 21 randomized controlled trials, 629 patients)
  164. Hamamci N, Dursun E, Ural C, Cakci A. Calcitonin treatment in reflex sympathetic dystrophy: a preliminary study. Br J Clin Pract. 1996;50(7):373-375. (Randomized placebo-controlled; 41 patients)
  165. Christensen K, Jensen EM, Noer I. The reflex dystrophy syndrome response to treatment with systemic corticosteroids. Acta Chir Scand. 1982;148(8):653-655. (Prospective randomized placebo-controlled; 23 patients)
  166. Adami S, Fossaluzza V, Gatti D, et al. Bisphosphonate therapy of reflex sympathetic dystrophy syndrome. Ann Rheum Dis. 1997;56(3):201-204. (Prospective randomized double-blinded placebo-controlled; 20 patients)
  167. Varenna M, Zucchi F, Ghiringhelli D, et al. Intravenous clodronate in the treatment of reflex sympathetic dystrophy syndrome. A randomized, double blind, placebo controlled study. J Rheumatol. 2000;27(6):1477-1483. (Prospective randomized double-blind placebo-controlled; 32 patients)
  168. Straube S, Derry S, Moore RA, et al. Cervico-thoracic or lumbar sympathectomy for neuropathic pain and complex regional pain syndrome. Cochrane Database Syst Rev. 2010(7):CD002918. (Systematic review; 20 patients)
  169. Cepeda MS, Carr DB, Lau J. Local anesthetic sympathetic blockade for complex regional pain syndrome. Cochrane Database Syst Rev. 2005(4):CD004598. (Systematic review)
  170. Karanikolas M, Aretha D, Tsolakis I, et al. Optimized perioperative analgesia reduces chronic phantom limb pain intensity, prevalence, and frequency: a prospective, randomized, clinical trial. Anesthesiology. 2011;114(5):1144-1154. (Randomized controlled; 65 patients)
  171. Flor H. Phantom-limb pain: characteristics, causes, and treatment. Lancet Neurol. 2002;1(3):182-189. (Review)
  172. Baron R, Wasner G, Lindner V. Optimal treatment of phantom limb pain in the elderly. Drugs Aging. 1998;12(5):361-376. (Review)
  173. Jaeger H, Maier C. Calcitonin in phantom limb pain: a double-blind study. Pain. 1992;48(1):21-27. (Prospective double-blind placebo-controlled crossover; 21 patients)
  174. Knox DJ, McLeod BJ, Goucke CR. Acute phantom limb pain controlled by ketamine. Anaesth Intensive Care. 1995;23(5):620-622. (Case report; 1 patient)
  175. Nikolajsen L, Hansen CL, Nielsen J, et al. The effect of ketamine on phantom pain: a central neuropathic disorder maintained by peripheral input. Pain. 1996;67(1):69-77. (Prospective randomized double-blind crossover; 11 patients)
  176. Eichenberger U, Neff F, Sveticic G, et al. Chronic phantom limb pain: the effects of calcitonin, ketamine, and their combination on pain and sensory thresholds. Anesth Analg. 2008;106(4):1265-1273. (Prospective randomized double-blind crossover; 20 patients)
  177. Ben Abraham R, Marouani N, Weinbroum AA. Dextromethorphan mitigates phantom pain in cancer amputees. Ann Surg Oncol. 2003;10(3):268-274. (Prospective randomized double-blind crossover; 10 patients)
  178. Alviar MJ, Hale T, Dungca M. Pharmacologic interventions for treating phantom limb pain. Cochrane Database Syst Rev. 2011(12):CD006380. (Systematic review; 13 studies with 255 patients)
  179. Bartusch SL, Sanders BJ, D’Alessio JG, et al. Clonazepam for the treatment of lancinating phantom limb pain. Clin J Pain. 1996;12(1):59-62. (Case series; 2 patients)
  180. Vichitrananda C, Pausawasdi S. Midazolam for the treatment of phantom limb pain exacerbation: preliminary reports. J Med Assoc Thai. 2001;84(2):299-302. (Case series; 2 patients)
  181. Robinson LR, Czerniecki JM, Ehde DM, et al. Trial of amitriptyline for relief of pain in amputees: results of a randomized controlled study. Arch Phys Med Rehabil. 2004;85(1):1-6. (Prospective randomized placebo-controlled; 39 patients)
  182. Kelly A, Brumby C, Barnes C. Nurse-initiated, titrated intravenous opioid analgesia reduces time to analgesia for selected painful conditions. Can J Emerg Med. 2005;7:149-154. (Retrospective; 157 patients)
  183. Meunier-Sham J, Ryan K. Reducing pediatric pain during ED procedures with a nurse-driven protocol: an urban pediatric emergency department’s experience. J Emerg Nurs. 2003;29(2):127-132. (Case series)
  184. Fry M, Holdgate A. Nurse-initiated intravenous morphine in the emergency department: efficacy, rate of adverse events and impact on time to analgesia. Emerg Med (Fremantle). 2002;14(3):249-254. (Prospective; 202 patients)
  185. Fry M, Ryan J, Alexander N. A prospective study of nurse initiated panadeine forte: expanding pain management in the ED. Accid Emerg Nurs. 2004;12(3):136-140. (Prospective; 202 patients)
  186. Rahman NH, Desilva T. The effectiveness of patient control analgesia in the treatment of acute traumatic pain in the emergency department: a randomized controlled trial. Eur J Emerg Med. 2012;19(4):241-245. (Prospective randomized; 47 patients)
  187. Turturro M, Paris P, Seaberg D. Intramuscular ketorolac versus oral ibuprofen in acute musculoskeletal pain. Ann Emerg Med. 1995;26:117-120. (Prospective randomized double-blind placebo-controlled; 82 patients)