THERAPEUTIC APPROACH TO ACUTE PAIN IN POLYTRAUMA PATIENTS: an integrative review

• DOI: https://doi.org/10.22533/at.ed.1595352524123

• Palavras-chave: Pain Management; Multiple Trauma; Analgesia; Acute Pain.

• Keywords: Pain Management; Multiple Trauma; Analgesia; Acute Pain.

• Abstract:

  Introduction: Trauma is a serious global public health problem, with high morbidity and mortality rates. Acute pain is a frequent experience in polytrauma victims, but its clinical management remains inadequate, characterized by undertreatment, variability in approaches, and significant organizational barriers. This gap between guidelines and practice, accentuated in contexts of limited resources, negatively impacts patient stabilization and clinical outcomes. Methods: An integrative review was conducted with a search of the PubMed, BVS, SciELO, and ScienceDirect databases, considering the period from 2015 to 2025 and including clinical trials that addressed the management of acute pain in polytrauma patients in emergency services. After a screening process, eight studies were eligible for final analysis. Results: The synthesis of the studies confirmed the prevalence of undertreatment and inconsistent pain assessment. Organizational strategies, such as the implementation of standardized protocols combined with staff training, have been shown to significantly improve the quality of analgesic management. Pharmacologically, multimodal analgesia has proven effective, with combinations such as nalbuphine and paracetamol standing out. Inhaled methoxyflurane emerged as a promising, effective, and safe alternative. At the same time, outdated practices, such as resuscitation with synthetic colloids, were identified as being associated with an increase in complications. Conclusion: It is concluded that effective pain management in polytrauma patients is a multifactorial challenge that transcends simple pharmacological choices. It is imperative to integrate standardized clinical protocols, continuously invest in team training, and adopt a care culture that prioritizes early, evidence-based analgesia as an essential component of resuscitation, adapting to local realities to optimize patient prognosis.