[Analgesia for the patient with multiple injuries.].
Beside the procedures to ensure adequate ventilatory and circulatory support, analgesia, sedation and even anesthesia are essential parts of the preclinical treatment of patients with multiple injuries. The measures for extrication and positioning must be adjusted to minimize pain and excitation. Opioids and ketamine are the most suitable substances for pain control in these patients. According to modern emergency-medicine standards in countries with advanced physician-staffed intensive care ambulance units, the induction of anesthesia offers the best prospects for eliminating pain while securing an adequate gas exchange in these patients. The therapy must take into account the special conditions concerning the patient, material and assisting personnel by choosing suitable techniques. The best results can be obtained if all kinds of measures can be administered from the site of the accident on up to the definitive care in the operating room.
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Universitätsklinik für Anästhesiologie-Sektion Notfallmedizin, Klinikum der Universität, Prittwitzstraße 43, W-7900, Ulm.