Pain in Patients with Polytrauma: A Systematic Review [Internet]

Excerpt

Polytrauma is defined in the VHA Polytrauma Rehabilitation Centers Directive dated June 8, 2005 as: “injury to the brain in addition to other body parts or systems resulting in physical, cognitive, psychological, or psychosocial impairments and functional disability.” The definition of polytrauma has since expanded to include concurrent injury to two or more body parts or systems that results in cognitive, physical, psychological or other psychosocial impairments. Traumatic Brain Injury (TBI) often occurs in polytrauma and in combination with other disabling conditions including amputation, auditory or visual impairments, spinal cord injury (SCI), post-traumatic stress disorder (PTSD), and other mental health conditions.

Pain resulting from polytraumatic injuries poses numerous challenges during rehabilitation treatment and afterwards. Treatments typically used to reduce pain in these individuals (for example, oral opioids) have the potential to interfere with the active rehabilitation needed to restore function.

The objectives of this report are to systematically review the literature to address the assessment and management of pain in patients with polytraumatic injuries, to identify patient, clinician and systems factors associated with pain-related outcomes in these patients, and to describe current or planned research addressing the key questions.