Pre-hospital traumatic pain management in Lower Austria
DOI:
https://doi.org/10.31247/agnj.v3iS1.72Keywords:
Pre-hospital emergency medicine, pain management, emergency, Notfallmedizin, Notfallsanitäter:innen, Präklinische Notfallmedizin, Lower Austria, Methoxyflurane, opioids, Esketamine, traumaAbstract
Research question / Study objective This study aims to add knowledge on possible differences in pain reduction between Methoxyflurane, Esketamine and opioids. Specifically, this study is designed to answer the question, whether the percentage of patients experiencing pain relief by inhalational Methoxyflurane is significantly different compared to Esketamine or opioids administered intravenously.
Methods The study is conducted by a retrospective analysis of patient charts, provided by the Red Cross Lower Austria, in a dataset consisting of 946 initial observations. For testing the main hypothesis, 336 observations were evaluated between Methoxyflurane and Esketamine, 366 regarding opioids. The ethical considerations regarding the Helsinki declaration were closely followed and approved by the Ethics Committee of the Karl Landsteiner University (EK-Nr.: 1080/2024).
Results The p-values of the performed χ2 tests were well below the adjusted threshold of <0.025 (Bonferroni correction) with 0.0025 and 0.0014. Both χ2 tests were significant. The OR in the Esketamine subgroup could not be ascertained, the OR in the opioid subgroup was high with OR = 6.16, the corresponding 95%- CI was ranging from 1.9 to 31.5, relativising the result. The effect size of Cramér’s V was small in both occasions with 0.165 and 0.167, further limiting the result.
Discussion / Conclusion To conclude, there is a significant difference between the percentages of patients experiencing pain relief by Methoxyflurane in comparison to Esketamine and opioids. Patients receiving Methoxyflurane less frequently achieved a reduction in pain than their counterparts treated with opioids or Esketamine. However, as mentioned above, the small effect size and large 95%-CI relativise these results, leaving them only as possible guidance when choosing an intervention. Further research is needed to put the results into perspective, preferably large, randomised and prospective trials in the pre-hospital setting.
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