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Opioid-Minimizing Pain Management Feasible for Trauma Patients

MAST MMPR regimen includes oral acetaminophen, naproxen, gabapentin, lidocaine patches, and as-needed opioids

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WEDNESDAY, Feb 3, 2021 (HealthDay News) -- A pain management regimen that uses mostly over-the-counter medication reduces opioid exposure in trauma patients while achieving similar levels of pain control, according to a study published online Jan. 21 in the Journal of the American College of Surgeons.

John A. Harvin, M.D., from the University of Texas Health Science Center in Houston, and colleagues compared two multimodal pain regimens (MMPR) for minimizing opioid exposure and relieving acute pain in a busy, urban trauma center. The two interventions were the original MMPR (787 patients; intravenous administration followed by oral acetaminophen, 48 hours of celecoxib and pregabalin followed by naproxen and gabapentin, scheduled tramadol, and as-needed oxycodone) and MAST (Multimodal Analgesic Strategies in Trauma) MMPR using generic medications (774 patients; oral acetaminophen, naproxen, gabapentin, lidocaine patches, and as-needed opioids).

The researchers found that patients randomly assigned to the MAST MMPR had lower morphine milligram equivalents (MME) per day (34 MME/day versus 48 MME/day). Additionally, fewer patients in the MAST MMPR group were prescribed opioids at discharge (62 versus 67 percent; relative risk, 0.92). There were no clinically significant differences noted between the groups for pain scores.

"The MAST MMPR was a generalizable and widely available approach that reduced opioid exposure after trauma and achieved adequate acute pain control," the authors write.

One author disclosed financial ties to the pharmaceutical industry.

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