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<< Pain Management in the Emergency Department

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, such
as the type of study and the number of patients in the study, will be included in bold type following the reference, where available.

  1. Wilson JE, Pendleton JM. Oligoanalgesia in the emergency department. Am J Emerg Med. Nov 1989;7(6):620-623. (Review, 198 patients)
  2. Rupp T, Delaney KA. Inadequate analgesia in emergency medicine. Ann Emerg Med. Apr 2004;43(4):494-503. (Review)
  3. Wilsey B, Fishman S, Rose JS, Papazian J. Pain management in the ED. Am J Emerg Med. Jan 2004;22(1):51-57. (Review)
  4. Stahmer SA, Shofer FS, Marino A, Shepherd S, Abbuhl S. Do quantitative changes in pain intensity correlate with pain relief and satisfaction? Acad Emerg Med. Sep 1998;5(9):851-857. (Prospective, single-group repeated-measures study, 81 patients)
  5. Todd KH, Sloan EP, Chen C, Eder SC, Wamstad K. Survey of Pain in Etiology, Management Practices and Patient Satisfaction in Two Urban Emergency Departments. CJEM. Vol 4; 2002. (Cross-sectional study, 525 patients)
  6. Melzack R, Wall PD, Ty TC. Acute pain in an emergency clinic: latency of onset and descriptor patterns related to different injuries. Pain. Sep 1982;14(1):33-43. (Prospective study, 138 patients)
  7. Stalnikowicz R, Mahamid R, Kaspi S, Brezis M. Undertreatment of acute pain in the emergency department: a challenge. Int J Qual Health Care. Apr 2005;17(2):173-176. (Before-after study, 140 patients)
  8. Kozlowski MJ, Wiater JG, Pasqual RG, Compton S, Swor RA, Jackson RE. Painful discrimination: the differential use of analgesia in isolated lower limb injuries. Am J Emerg Med. Oct 2002;20(6):502-505. (Prospective, blinded cohort study, 384 patients)
  9. Ducharme J, Barber C. A prospective blinded study on emergency pain assessment and therapy. J Emerg Med. Jul-Aug 1995;13(4):571-575. (Prospective, blinded study, 42 patients)
  10. Tanabe P, Buschmann M. A prospective study of ED pain management practices and the patient’s perspective. J Emerg Nurs. Jun 1999;25(3):171-177. (Prospective study, 203 patients)
  11. Singer AJ, Thode HC, Jr. National analgesia prescribing patterns in emergency department patients with burns. J Burn Care Rehabil. Nov-Dec 2002;23(6):361-365. (Secondary analysis of national, weighted, sample of ED encounters)
  12. McNamara RM, Rousseau E, Sanders AB. Geriatric emergency medicine: a survey of practicing emergency physicians. Ann Emerg Med. Jul 1992;21(7):796-801. (Prospective survey, 971 patients)
  13. Marks RM, Sachar EJ. Undertreatment of medical inpatients with narcotic analgesics. Ann Intern Med. Feb 1973;78(2):173-181. (Survey)
  14. McEachin CC, McDermott JT, Swor R. Few emergency medical services patients with lower-extremity fractures receive prehospital analgesia. Prehosp Emerg Care. Oct-Dec 2002;6(4):406-410. (Retrospective study, 124 patients)
  15. Sengstaken EA, King SA. The problems of pain and its detection among geriatric nursing home residents. J Am Geriatr Soc. May 1993;41(5):541-544. (Chart review study, 100 patients)
  16. Won A, Lapane K, Gambassi G, Bernabei R, Mor V, Lipsitz LA. Correlates and management of nonmalignant pain in the nursing home. SAGE Study Group. Systematic Assessment of Geriatric drug use via Epidemiology. J Am Geriatr Soc. Aug 1999;47(8):936-942. (Cross-sectional study, 49,971 patients)
  17. Ngai B, Ducharme J. Documented use of analgesics in the emergency department and upon release of patients with extremity fractures. Acad Emerg Med. Dec 1997;4(12):1176-1178.(Retrospective study)
  18. Chambers CT, Reid GJ, Craig KD, McGrath PJ, Finley GA.Agreement between child and parent reports of pain. Clin J Pain. Dec 1998;14(4):336-342. (Prospective study, 110 patients)
  19. Breau LM, MacLaren J, McGrath PJ, Camfield CS, Finley GA. Caregivers’ beliefs regarding pain in children with cognitive impairment: relation between pain sensation and reaction increases with severity of impairment. Clin J Pain. Nov-Dec 2003;19(6):335-344. (Retrospective survey, 65 caregivers)
  20. Todd KH. Emergency medicine and pain: a topography of influence. Ann Emerg Med. Apr 2004;43(4):504-506. (Editorial)
  21. Johnston CC, Gagnon AJ, Fullerton L, Common C, Ladores M, Forlini S. One-week survey of pain intensity on admission to and discharge from the emergency department: a pilot study. J Emerg Med. May-Jun 1998;16(3):377-382. (Pilot survey)
  22. Cordell WH, Keene KK, Giles BK, Jones JB, Jones JH, Brizendine EJ. The high prevalence of pain in emergency medical care. Am J Emerg Med. May 2002;20(3):165-169. (Retrospective, cross-sectional study, 1,665 patients)
  23. Trotter G. Calling other emergency departments about suspicious patients. 2nd ed. Tucson, AZ: Galen Press; 1995. (Book chapter)
  24. Stewart WF, Ricci JA, Chee E, Morganstein D, Lipton R. Lost productive time and cost due to common pain conditions in the US workforce. Jama. Nov 12 2003;290(18):2443-2454. (Cross-sectional survey study, 23,902 surveys)
  25. Elliott AM, Smith BH, Penny KI, Smith WC, Chambers WA. The epidemiology of chronic pain in the community. Lancet. Oct 9 1999;354(9186):1248-1252. (Questionnaire, 3,605 patients)
  26. Picavet HS, Schouten JS, Smit HA. Prevalence and consequences of low back problems in The Netherlands, working vs non-working population, the MORGEN-Study. Monitoring Project on Risk Factors for Chronic Disease. Public Health. Mar 1999;113(2):73-77. (Cross-sectional questionnaire, 13,822 patients)
  27. Mannix LK. Epidemiology and impact of primary headache disorders. Med Clin North Am. Jul 2001;85(4):887-895. (Review)
  28. Ducharme J. Emergency pain management: a Canadian Association of Emergency Physicians (CAEP) consensus document. J Emerg Med. Nov-Dec 1994;12(6):855-866. (Consensus statement)
  29. Singer AJ, Richman PB, Kowalska A, Thode HC, Jr. Comparison of patient and practitioner assessments of pain from commonly performed emergency department procedures. Ann Emerg Med. Jun 1999;33(6):652-658. (Prospective, observational, cross-sectional study, 1,171 patients)
  30. Guru V, Dubinsky I. The patient vs. caregiver perception of acute pain in the emergency department. J Emerg Med. Jan 2000;18(1):7-12. (Convenience cohort, 71 patients)
  31. Eder SC, Sloan EP, Todd K. Documentation of ED patient pain by nurses and physicians. Am J Emerg Med. Jul 2003;21(4):253-257. (Prospective survey plus chart review, 302 patients)
  32. American Academy of Pediatrics. The assessment and Management of Acute Pain in Infants, Children, and Adolescents. Pediatrics. September 2001;108(3):793-797. (Policy statement)
  33. Jones JS, Johnson K, McNinch M. Age as a risk factor for inadequate emergency department analgesia. Am J Emerg Med. Mar 1996;14(2):157-160. (Retrospective, cohort study, 231 patients)
  34. Carr TD, Lemanek KL, Armstrong FD. Pain and fear ratings: clinical implications of age and gender differences. J Pain Symptom Manage. May 1998;15(5):305-313. (Prospective, interview, 62 patients)
  35. Kelly AM. Does the clinically significant difference in visual analog scale pain scores vary with gender, age, or cause of pain? Acad Emerg Med. Nov 1998;5(11):1086-1090. (Prospective, descriptive study, 152 patients)
  36. Todd KH, Deaton C, D’Adamo AP, Goe L. Ethnicity and analgesic practice. Ann Emerg Med. Jan 2000;35(1):11-16. (Retrospective, cohort study, 217 patients)
  37. Abu-Saad H. Cultural group indicators of pain in children. Matern Child Nurs J. Fall 1984;13(3):187-196. (Review)
  38. Flores G, Abreu M, Schwartz I, Hill M. The importance of language and culture in pediatric care: case studies from the Latino community. J Pediatr. Dec 2000;137(6):842-848. (Case analysis, 3 cases)
  39. Assessment and Management of Acute Pain. Web Page] Health Care Guideline. Available at: . Accessed April 25, 2006. (Guideline)
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  41. Ribbers GM, Geurts AC, Stam HJ, Mulder T. Pharmacologic treatment of complex regional pain syndrome I: a conceptual framework. Arch Phys Med Rehabil. Jan 2003;84(1):141-146. (Review)
  42. Assessment and Management of Chronic Pain. Web Page] . Accessed April 25, 2006. (Guideline)
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  44. Gottschalk A, Smith DS. New concepts in acute pain therapy: preemptive analgesia. Am Fam Physician. May 15 2001;63(10):1979-1984. (Review)
  45. Ong CK, Lirk P, Seymour RA, Jenkins BJ. The efficacy of preemptive analgesia for acute postoperative pain management: a meta-analysis. Anesth Analg. Mar 2005;100(3):757-773. (Meta-analysis)
  46. McLean SA, Maio RF, Domeier RM. The epidemiology of pain in the prehospital setting. Prehosp Emerg Care. Oct-Dec 2002;6(4):402-405. (Cross-sectional data on probability sampleof 21,103 ED visits)
  47. Abbuhl FB, Reed DB. Time to analgesia for patients with painful extremity injuries transported to the emergency department by ambulance. Prehosp Emerg Care. Oct-Dec 2003;7(4):445-447. (Retrospective chart review, 104 patients)
  48. Vassiliadis J, Hitos K, Hill CT. Factors influencing prehospital and emergency department analgesia administration to patients with femoral neck fractures. Emerg Med (Fremantle). Sep 2002;14(3):261-266. (Retrospective analysis, 176 patients)
  49. Swor R, McEachin CM, Seguin D, Grall KH. Prehospital pain management in children suffering traumatic injury. Prehosp Emerg Care. Jan-Mar 2005;9(1):40-43. (Retrospective study, 73 children)
  50. Hennes H, Kim MK, Pirrallo RG. Prehospital pain management: a comparison of providers’ perceptions and practices. Prehosp Emerg Care. Jan-Mar 2005;9(1):32-39. (Cross-sectional survey, 202 paramedics)
  51. Watkins N. Paediatric prehospital analgesia in Auckland. Emerg Med Australas. Feb 2006;18(1):51-56. (Prospective study, 35 children)
  52. French SC, Salama NP, Baqai S, Raslavicus S, Ramaker J, Chan SB. Effects of an educational intervention on prehospital pain management. Prehosp Emerg Care. Jan-Mar 2006;10(1):71-76. (Randomized, controlled trial, 149 patients)
  53. Nuhr M, Hoerauf K, Bertalanffy A, et al. Active warming during emergency transport relieves acute low back pain. Spine. Jul 15 2004;29(14):1499-1503. (Case-control study, 100 patients)
  54. Kanowitz A, Dunn TM, Kanowitz EM, Dunn WW, Vanbuskirk K. Safety and effectiveness of fentanyl administration for prehospital pain management. Prehosp Emerg Care. Jan-Mar 2006;10(1):1-7. (Retrospective chart review, 2,129 patients)
  55. Galinski M, Dolveck F, Borron SW, et al. A randomized, double-blind study comparing morphine with fentanyl in prehospital analgesia. Am J Emerg Med. Mar 2005;23(2):114-119. (Prospective, comparative study, 26 patients)
  56. Faddy SC, Garlick SR. A systematic review of the safety of analgesia with 50% nitrous oxide: can lay responders use analgesic gases in the prehospital setting? Emerg Med J. Dec 2005;22(12):901-908. (Review)
  57. Bledsoe B, Braude D, Dailey MW, Myers J, Richards M, Wesley K. Simplifying prehospital analgesia. Why certain medications should or should not be used for pain management in the field. Jems. Jul 2005;30(7):56-63. (Review)
  58. Pons PT. Nitrous oxide analgesia. Emerg Med Clin North Am. Nov 1988;6(4):777-782. (Review)
  59. Mystakidou K, Parpa E, Katsouda E, Galanos A, Vlahos L. Pain and desire for hastened death in terminally ill cancer patients. Cancer Nurs. Jul-Aug 2005;28(4):318-324. (Survey study, 120 patients)
  60. Tousignant-Laflamme Y, Rainville P, Marchand S. Establishing a link between heart rate and pain in healthy subjects: a gender effect. J Pain. Jun 2005;6(6):341-347. (Clinical study, 39 patients)
  61. Silka PA, Roth MM, Moreno G, Merrill L, Geiderman JM. Pain scores improve analgesic administration patterns for trauma patients in the emergency department. Acad Emerg Med. Mar 2004;11(3):264-270. (Prospective, observational study, 150 patients)
  62. Bijur PE, Silver W, Gallagher EJ. Reliability of the visual analog scale for measurement of acute pain. Acad Emerg Med. Dec 2001;8(12):1153-1157. (Prospective study of 2 EDs)
  63. Gallagher EJ, Liebman M, Bijur PE. Prospective validation of clinically important changes in pain severity measured on a visual analog scale. Ann Emerg Med. Dec 2001;38(6):633-638. (Prospective, observational cohort study, 96 patients)
  64. Todd KH, Funk KG, Funk JP, Bonacci R. Clinical significance of reported changes in pain severity. Ann Emerg Med. Apr 1996;27(4):485-489. (Prospective interview, 48 patients)
  65. Bijur PE, Latimer CT, Gallagher EJ. Validation of a verbally administered numerical rating scale of acute pain for use in the emergency department. Acad Emerg Med. Apr 2003;10(4):390-392. (Prospective cohort, 108 patients)
  66. Berthier F, Potel G, Leconte P, Touze MD, Baron D. Comparative study of methods of measuring acute pain intensity in an ED. Am J Emerg Med. Mar 1998;16(2):132-136. (Comparative study, 290 patients)
  67. Kendrick DB, Strout TD. The minimum clinically significant difference in patient-assigned numeric scores for pain. Am J Emerg Med. Nov 2005;23(7):828-832. (Prospective study, 354 patients)
  68. Fosnocht DE, Chapman CR, Swanson ER, Donaldson GW. Correlation of change in visual analog scale with pain relief in the ED. Am J Emerg Med. Jan 2005;23(1):55-59. (Prospective, observational study, 1,490 patients)
  69. Bird SB, Dickson EW. Clinically Significant Chages in Pain Along the Visual Analog Scale. Ann Emerg Med. December 2001;38(6):639-643. (Prospective, convenience study, 77 patients)
  70. McGrath PA, Seifert CE, Speechley KN, Booth JC, Stitt L, Gibson MC. A new analogue scale for assessing children’s pain: an initial validation study. Pain. Mar 1996;64(3):435-443. (Comparison study, 104 patients)
  71. McGrath PJJ, G.; Goodman, J.T.; Schillinger, J.; Dunn, J.; and Chapman, J.-A. CHEOPS: a behavioral scale for rating postoperative pain in children. Vol 9. New York: Raven Press; 1985. (Textbook)
  72. Suraseranivongse S, Santawat U, Kraiprasit K, Petcharatana S, Prakkamodom S, Muntraporn N. Cross-validation of a composite pain scale for preschool children within 24 hours of surgery. Br J Anaesth. Sep 2001;87(3):400-405. (Cross-validation study, 167 patients)
  73. Breau LM, Finley GA, McGrath PJ, Camfield CS. Validation of the Non-communicating Children’s Pain Checklist-Postoperative Version. Anesthesiology. Mar 2002;96(3):528-535. (Prospective, interview, 24 caregivers)
  74. Rose VL. Guidelines from the American Geriatric Society target management of chronic pain in older persons. Am Fam Physician. Oct 1 1998;58(5):1213-1214, 1217. (Practice guideline)
  75. Porter J, Jick H. Addiction rare in patients treated with narcotics. N Engl J Med. Jan 10 1980;302(2):123. (Letter)
  76. Jamison RN, Raymond SA, Slawsby EA, Nedeljkovic SS, Katz NP. Opioid therapy for chronic noncancer back pain. A randomized prospective study. Spine. Dec 1 1998;23(23):2591-2600. (Randomized, controlled trial, 36 patients)
  77. Catapano MS. The analgesic efficacy of ketorolac for acute pain. J Emerg Med. Jan-Feb 1996;14(1):67-75. (Review)
  78. Schwartz NA, Turturro MA, Istvan DJ, Larkin GL. Patients’ perceptions of route of nonsteroidal anti-inflammatory drug administration and its effect on analgesia. Acad Emerg Med. Aug 2000;7(8):857-861. (Randomized, controlled trial, 64 patients)
  79. Galer BS, Rowbotham MC, Perander J, Friedman E. Topical lidocaine patch relieves postherpetic neuralgia more effectively than a vehicle topical patch: results of an enriched enrollment study. Pain. Apr 1999;80(3):533-538. (Randomized, controlled trial, 32 patients)
  80. Devers A, Galer BS. Topical lidocaine patch relieves a variety of neuropathic pain conditions: an open-label study. Clin J Pain. Sep 2000;16(3):205-208. (Open-label study, 16 patients)
  81. Dalpiaz AS, Lordon SP, Lipman AG. Topical lidocaine patch therapy for myofascial pain. J Pain Palliat Care Pharmacother. 2004;18(3):15-34. (Open-label study, 27 patients)
  82. Alexander J, Manno M. Underuse of analgesia in very young pediatric patients with isolated painful injuries. Ann Emerg Med. May 2003;41(5):617-622. (Retrospective chart review, 180 patients)
  83. Galer BS, Sheldon E, Patel N, Codding C, Burch F, Gammaitoni AR. Topical lidocaine patch 5% may target a novel underlying pain mechanism in osteoarthritis. Curr Med Res Opin. Sep 2004;20(9):1455-1458. (Open-label study, 20 patients)
  84. Gammaitoni AR, Alvarez NA, Galer BS. Pharmacokinetics and safety of continuously applied lidocaine patches 5%. Am J Health Syst Pharm. Nov 15 2002;59(22):2215-2220. (Randomized, controlled trial, 20 patients)
  85. Campbell BJ, Rowbotham M, Davies PS, Jacob P, 3rd, Benowitz NL. Systemic absorption of topical lidocaine in normal volunteers, patients with post-herpetic neuralgia, and patients with acute herpes zoster. J Pharm Sci. May 2002;91(5):1343-1350. (Basic science)
  86. Bauman BH, McManus JG, Jr. Pediatric pain management in the emergency department. Emerg Med Clin North Am. May 2005;23(2):393-414, ix. (Review)
  87. Altier N, Dion D, Boulanger A, Choiniere M. Management of chronic neuropathic pain with methadone: a review of 13 cases. Clin J Pain. Jul-Aug 2005;21(4):364-369. (Case review, 13 cases)
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  90. Likar R, Schafer M, Paulak F, et al. Intraarticular morphine analgesia in chronic pain patients with osteoarthritis. Anesth Analg. Jun 1997;84(6):1313-1317. (Randomized, controlled trial, 23 patients)
  91. Khoury GF, Garland DE, Stein C. Intraarticular opioid-local anesthetic combinations for chronic joint pain. Middle East J Anesthesiol. Oct 1994;12(6):579-585. (Case report)
  92. McCleane G. Topical application of doxepin hydrochloride can reduce the symptoms of complex regional pain syndrome: a case report. Injury. Jan 2002;33(1):88-89. (Case report)
  93. Lynch ME, Clark AJ, Sawynok J, Sullivan MJ. Topical amitriptyline and ketamine in neuropathic pain syndromes: an open-label study. J Pain. Oct 2005;6(10):644-649. (Openlabel study, 21 patients)
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  116. An Act to amend the Controlled Substances Act to promote pain management and palliative care without permitting assisted suicide and euthanasia, and for other purposes. Hyde H, trans. 106th ed; 1999. (Congressional bill)
  117. To declare adequate pain care research, education, and treatment as national public health priorities, and for other purposes. (MI) R, trans. 109th ed; 2005. (Congressional bill)
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  123. American College of Emergency Physicians Policy Statement #400335: Pain Management in the Emergency Department. . Accessed February, 2006. (Policy statement)
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  129. Pace S, Burke TF. Intravenous morphine for early pain relief in patients with acute abdominal pain. Acad Emerg Med. Dec 1996;3(12):1086-1092. (Randomized, controlled trial, 75 patients)
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  134. Tait IS, Ionescu MV, Cuschieri A. Do patients with acute abdominal pain wait unduly long for analgesia? J R Coll Surg Edinb. Jun 1999;44(3):181-184. (Prospective audit, 100 ED admissions)
  135. Shabbir J, Ridgway PF, Lynch K, et al. Administration of analgesia for acute abdominal pain sufferers in the accident and emergency setting. Eur J Emerg Med. Dec 2004;11(6):309-312. (Prospective study, 107 patients)
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