Fast Five Quiz: Overview of Acute Pain Management

Shaheen E. Lakhan, MD, PhD, MS, MEd


January 14, 2022

Figure 1. Health professionals evaluating a patient's pain.

Although multimodal analgesia is the preferred strategy, most patients will need pharmacologic therapy after sustaining a traumatic injury. For certain patients with opioid tolerance, it may be useful to convert to another opioid in the acute care setting, rather than increasing doses.

Despite being a common concern, NSAID use after trauma does not impair wound and fracture healing. However, long-term (2 weeks or longer) use of NSAIDs should be avoided in the setting of fracture.

Screening patients for factors that may increase their risk for overdose or substance abuse is essential before initiating opioid therapy. Younger patients are at increased risk for substance abuse, whereas older patients are at increased risk for overdose. Other pertinent factors to consider include:

  • Personal or family history of substance abuse or overdose

  • Depression or other mental health diagnosis

  • Underlying renal, hepatic, or pulmonary dysfunction

Long-acting products (eg, extended-release opioids and transdermal preparations) are not appropriate for treatment of acute pain and should not be used.

Learn more about emergency pharmacologic management of acute pain.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.