Pain Assessment Following Opioid Administration in Aneurysmal Subarachnoid Hemorrhage Associated Headache.
J Pharm Pract
; : 8971900241248481, 2024 Apr 16.
Article
in En
| MEDLINE
| ID: mdl-38627957
ABSTRACT
Background:
Headache is a debilitating complication following an aneurysmal subarachnoid hemorrhage (aSAH). Despite its impact on morbidity and quality of life, limited evidence characterizes the effectiveness of opioids.Objective:
The aim of this study was to evaluate opioid associated reduction in pain scores in patients with aSAH-associated headache.Methods:
This is a retrospective study of adult patients with an aSAH, Hunt and Hess grades I - III, admitted to a neurosciences intensive care unit. Descriptive and inferential statistics were used to characterize headache treatment strategies and opioid associated reduction in pain scores.Results:
Opioids were used in up to 97.6% of patients for the management of aSAH-associated headache. Median reduction in pain after opioid administration was -1 (IQR -3-0). Correlation between opioid dose and change in pain scores was negligible (rs = .01). Overall, 68.8% of patients were discharged on an opioid analgesic with predictive factors being severe headache (OR 2.52; 1.04 - 6.14) and oral morphine milligram equivalents ≥60 mg per day during the hospital stay (OR 3.02; 1.22 - 7.47).Conclusions:
Opioids were associated with a small reduction in pain when assessed via the NRS. An increased opioid dose did not correlate with a greater reduction in assessed pain scores. A high percentage of patients remained on opioids throughout hospitalization and were eventually discharged on an opioid. The impact of discharge opioid prescriptions and risk of opioid persistence creates a cause for concern. It is imperative that we seek improved pain management strategies for aSAH-associated headache.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Language:
En
Journal:
J Pharm Pract
Journal subject:
FARMACIA
Year:
2024
Document type:
Article
Affiliation country:
Estados Unidos