PREOPERATIVE ANALGESIA AFTER INJURY

Much has been written on postoperative analgesia in the surgical patie nt. However, no work has been published on pre-operative pain relief i n acute injury. We have studied 100 consecutive admissions, reviewing the prescribing pattern and administration of analgesia following acut e injury in the period prior to operation, or the first 24 h as an in- patient. We found an over-reliance on a narrow range of analgesics to the exclusion of others. The choice and variety of analgesic offered t heir frequency and route of administration could all have been improve d. Equally, little thought was given to adjuvant forms of analgesic th erapy which are well suited to the injured patient. Analgesics were pr escribed move often than they were given. No pharmacological analgesia was prescribed in 9 per cent of admissions, and a further 14 per cent were given no analgesia despite its being prescribed, i.e. 23 per cen t of acutely injured patients received no analgesia during the pre-ope rative period, or first 24 h after admission. This audit revealed evid ence of inadequate pre-operative analgesic prescribing and administrat ion practices. We conclude that there is no place for complacency when managing the analgesic requirements of injured patients. Copyright (C ) 1996 Elsevier Science Ltd.