title: Pain management in trauma: A review study.
abstract: BACKGROUND
  Pain in trauma has a role similar to the double-edged sword. On the one hand, pain is a good indicator to determine the severity and type of injury. On the other hand, pain can induce sever complications and it may lead to further deterioration of the patient. Therefore, knowing how to manage pain in trauma patients is an important part of systemic approach in trauma. The aim of this manuscript is to provide information about pain management in trauma in the Emergency Room settings.
  
  
  METHODS
  In this review we searched among electronic and manual documents covering a 15-yr period between 2000 and 2016. Our electronic search included Pub Med, Google scholar, Web of Science, and Cochrane databases. We looked for articles in English and in peer-reviewed journals using the following keywords: acute pain management, trauma, emergency room and injury.
  
  
  RESULTS
  More than 3200 documents were identified. After screening based on the study inclusion criteria, 560 studies that had direct linkage to the study aim were considered for evaluation based World Health Organization (WHO) pain ladder chart.
  
  
  CONCLUSIONS
  To provide adequate pain management in trauma patients require: adequate assessment of age-specific pharmacologic pain management; identification of adequate analgesic to relieve moderate to severe pain; cognizance of serious adverse effects of pain medications and weighting medications against their benefits, and regularly reassessing patients and reevaluating their pain management regimen. Patient-centered trauma care will also require having knowledge of barriers to pain management and discussing them with the patient and his/her family to identify solutions.
authors.affiliation: Department of Anesthesiology, Critical Care and Pain Management, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran. Email: ahmadiar1012@yahoo.com.
authors.forename: Alireza
authors.initials: A
authors.lastname: Ahmadi
authors.forename: Shahrzad
authors.initials: S
authors.lastname: Bazargan-Hejazi
authors.forename: Zahra
authors.initials: Z
authors.lastname: Heidari Zadie
authors.forename: Pramote
authors.initials: P
authors.lastname: Euasobhon
authors.forename: Penkae
authors.initials: P
authors.lastname: Ketumarn
authors.forename: Ali
authors.initials: A
authors.lastname: Karbasfrushan
authors.forename: Javad
authors.initials: J
authors.lastname: Amini-Saman
authors.forename: Reza
authors.initials: R
authors.lastname: Mohammadi
mesh_terms: D004636:Emergency Service, Hospital; D006801:Humans; D059408:Pain Management / Q000379:methods; D014947:Wounds and Injuries / Q000150:complications* / Q000628:therapy