PAIN AND TREATMENT IN THORACIC TRAUMA

Abstract

Thoracic injury is a common type of trauma. The mechanics of chest injury are complex and varied. Morbidity and mortality are primarily determined by associated injuries and severe pain is one of the component. Associated pulmonary complication would be decreased with acute pain management modalities and development of chronic pain would be prevented. The pain management setting at the site of scene of accident and continuing at emergency unit, intensive care unit, during and after surgery is very important to decrese the percentage of morbidity and mortality. Opioids, adjuvant agents, regional techniques, operations would be performed to manage acute pain and prevent chronic pain according to the clinical situation of the patient. The success rate of pain management would be increased by combined management modalites and using imaging devices like ultrasonography during regional techniques.

Özet

Toraks travmas› s›k görülen bir travma çeflididir. Toraks travmas›nda mekanizma komplike ve de¤iflkendir. Morbidite ve mortalite efllik eden hasarlanmalarla belirlenir ve fliddetli a¤r› da bunun bir komponentidir. Akut a¤r› tedavisi ile efllik eden pulmoner komplikayonlar azalt›labilir, kronik a¤r› geliflimi önlenebilir. A¤r› tedavisinin olay yerinde bafllamas› acil serviste, yo¤un bak›mda, cerrahi s›ras›nda ve sonras›nda sürdürülmesi morbidite ve mortalite oranlar›n›n düflürülmesi aç›s›ndan çok önemlidir. Akut a¤r› tedavisi ve kronik a¤r› gelifliminin önlenmesi için opioidler, adjuvan ajanlar, rejyonel teknikler, cerrahi uygulamalar hastan›n klinik durumuna göre uygulan›r. Kombine tedavi uygulamalar› ve giriflimsel uygulamalarda USG gibi görüntüleme yöntemlerinin kullan›lmas› ile a¤r› tedavisinde baflar› oran› art›r›labilir.