Pain Management Strategies and Adverse Effects of Opioids in Patients with Neurotrauma with Acute and Chronic Pain

Pain is prevalent and a major source of disability after a traumatic brain injury (TBI) and a spinal cord injury (SCI). With a view of reducing the pain burden in neurotrauma, this study aimed to describe the use of pain management strategies and the adverse effects of opioids in patients with TBI a...

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Main Authors: Marie-Ève McGennis, Marc-Aurèle Gagnon, Jérôme Paquet, Alexis F. Turgeon, Tassia Macedo, Caroline Côté, Mwanack Kakule Matina, Michael Verret, Lynne Moore, Andréane Richard-Denis, Line Guénette, Léonie Archambault, Cécile Duval, Mélanie Bérubé
Format: Article
Language:English
Published: Mary Ann Liebert 2025-01-01
Series:Neurotrauma Reports
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Online Access:https://www.liebertpub.com/doi/10.1177/08977151251365585
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author Marie-Ève McGennis
Marc-Aurèle Gagnon
Jérôme Paquet
Alexis F. Turgeon
Tassia Macedo
Caroline Côté
Mwanack Kakule Matina
Michael Verret
Lynne Moore
Andréane Richard-Denis
Line Guénette
Léonie Archambault
Cécile Duval
Mélanie Bérubé
author_facet Marie-Ève McGennis
Marc-Aurèle Gagnon
Jérôme Paquet
Alexis F. Turgeon
Tassia Macedo
Caroline Côté
Mwanack Kakule Matina
Michael Verret
Lynne Moore
Andréane Richard-Denis
Line Guénette
Léonie Archambault
Cécile Duval
Mélanie Bérubé
author_sort Marie-Ève McGennis
collection DOAJ
description Pain is prevalent and a major source of disability after a traumatic brain injury (TBI) and a spinal cord injury (SCI). With a view of reducing the pain burden in neurotrauma, this study aimed to describe the use of pain management strategies and the adverse effects of opioids in patients with TBI and SCI. We collected data at hospital discharge (T1) and at 3 months post-injury (T2). A total of 70 patients, including 49 with TBI and 21 with SCI, with a mean age of 56 years (±21.1, ±17.9) were included. Almost a third of participants with TBI (33%) and SCI (29%) had a moderate average pain intensity at T1, and most experienced mild average pain intensity at T2. At T1, 80% of participants used opioids, whereas at T2, 26% of participants with TBI and 53% of those with SCI did. The main co-analgesic used was acetaminophen, with 78% and 17% for participants with TBI and 81% and 40% for participants with SCI at T1 and T2. The most common non-pharmacological strategy in participants with TBI was rest at T1 (45%) and T2 (32%), and comfortable positioning in participants with SCI at both timepoints (81% and 53%). The two most frequent adverse effects of opioids in both populations at T1 and T2 were drowsiness (35% vs. 43%; 10% vs. 13%) and constipation (27% vs. 38%; 7% vs. 20%). Opioids remain the most widely used pain management strategy in neurotrauma. Promoting a judicious use of opioids, combined with other strategies, could help patients with neurotrauma achieve adequate and safe pain relief.
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spelling doaj-art-71a3d17bc3324a2ab17643986fd5ef402025-08-20T08:09:01ZengMary Ann LiebertNeurotrauma Reports2689-288X2025-01-016168669910.1177/08977151251365585Pain Management Strategies and Adverse Effects of Opioids in Patients with Neurotrauma with Acute and Chronic PainMarie-Ève McGennis0Marc-Aurèle Gagnon1Jérôme Paquet2Alexis F. Turgeon3Tassia Macedo4Caroline Côté5Mwanack Kakule Matina6Michael Verret7Lynne Moore8Andréane Richard-Denis9Line Guénette10Léonie Archambault11Cécile Duval12Mélanie Bérubé13Population Health and Optimal Practices Research Unit (Trauma–Emergency–Critical Care Medicine), CHU de Québec-Université Laval Research Center, Québec City, Canada.Population Health and Optimal Practices Research Unit (Trauma–Emergency–Critical Care Medicine), CHU de Québec-Université Laval Research Center, Québec City, Canada.Department of Neurosciences, Service of Neurosurgery, CHU de Québec-Université Laval, Québec City, Canada.Population Health and Optimal Practices Research Unit (Trauma–Emergency–Critical Care Medicine), CHU de Québec-Université Laval Research Center, Québec City, Canada.Population Health and Optimal Practices Research Unit (Trauma–Emergency–Critical Care Medicine), CHU de Québec-Université Laval Research Center, Québec City, Canada.Population Health and Optimal Practices Research Unit (Trauma–Emergency–Critical Care Medicine), CHU de Québec-Université Laval Research Center, Québec City, Canada.Population Health and Optimal Practices Research Unit (Trauma–Emergency–Critical Care Medicine), CHU de Québec-Université Laval Research Center, Québec City, Canada.Population Health and Optimal Practices Research Unit (Trauma–Emergency–Critical Care Medicine), CHU de Québec-Université Laval Research Center, Québec City, Canada.Population Health and Optimal Practices Research Unit (Trauma–Emergency–Critical Care Medicine), CHU de Québec-Université Laval Research Center, Québec City, Canada.Department of Physical Medicine and Rehabilitation, Centre intégré universitaire du Nord de l’île-de-Montréal, Montréal, Canada.Quebec Pain Research Network, Sherbrooke, Canada.Quebec Pain Research Network, Sherbrooke, Canada.Population Health and Optimal Practices Research Unit (Trauma–Emergency–Critical Care Medicine), CHU de Québec-Université Laval Research Center, Québec City, Canada.Population Health and Optimal Practices Research Unit (Trauma–Emergency–Critical Care Medicine), CHU de Québec-Université Laval Research Center, Québec City, Canada.Pain is prevalent and a major source of disability after a traumatic brain injury (TBI) and a spinal cord injury (SCI). With a view of reducing the pain burden in neurotrauma, this study aimed to describe the use of pain management strategies and the adverse effects of opioids in patients with TBI and SCI. We collected data at hospital discharge (T1) and at 3 months post-injury (T2). A total of 70 patients, including 49 with TBI and 21 with SCI, with a mean age of 56 years (±21.1, ±17.9) were included. Almost a third of participants with TBI (33%) and SCI (29%) had a moderate average pain intensity at T1, and most experienced mild average pain intensity at T2. At T1, 80% of participants used opioids, whereas at T2, 26% of participants with TBI and 53% of those with SCI did. The main co-analgesic used was acetaminophen, with 78% and 17% for participants with TBI and 81% and 40% for participants with SCI at T1 and T2. The most common non-pharmacological strategy in participants with TBI was rest at T1 (45%) and T2 (32%), and comfortable positioning in participants with SCI at both timepoints (81% and 53%). The two most frequent adverse effects of opioids in both populations at T1 and T2 were drowsiness (35% vs. 43%; 10% vs. 13%) and constipation (27% vs. 38%; 7% vs. 20%). Opioids remain the most widely used pain management strategy in neurotrauma. Promoting a judicious use of opioids, combined with other strategies, could help patients with neurotrauma achieve adequate and safe pain relief.https://www.liebertpub.com/doi/10.1177/08977151251365585neurotraumaopioidspainpain management strategiesspinal cord injurytraumatic brain injury
spellingShingle Marie-Ève McGennis
Marc-Aurèle Gagnon
Jérôme Paquet
Alexis F. Turgeon
Tassia Macedo
Caroline Côté
Mwanack Kakule Matina
Michael Verret
Lynne Moore
Andréane Richard-Denis
Line Guénette
Léonie Archambault
Cécile Duval
Mélanie Bérubé
Pain Management Strategies and Adverse Effects of Opioids in Patients with Neurotrauma with Acute and Chronic Pain
Neurotrauma Reports
neurotrauma
opioids
pain
pain management strategies
spinal cord injury
traumatic brain injury
title Pain Management Strategies and Adverse Effects of Opioids in Patients with Neurotrauma with Acute and Chronic Pain
title_full Pain Management Strategies and Adverse Effects of Opioids in Patients with Neurotrauma with Acute and Chronic Pain
title_fullStr Pain Management Strategies and Adverse Effects of Opioids in Patients with Neurotrauma with Acute and Chronic Pain
title_full_unstemmed Pain Management Strategies and Adverse Effects of Opioids in Patients with Neurotrauma with Acute and Chronic Pain
title_short Pain Management Strategies and Adverse Effects of Opioids in Patients with Neurotrauma with Acute and Chronic Pain
title_sort pain management strategies and adverse effects of opioids in patients with neurotrauma with acute and chronic pain
topic neurotrauma
opioids
pain
pain management strategies
spinal cord injury
traumatic brain injury
url https://www.liebertpub.com/doi/10.1177/08977151251365585
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