Jurnal Internasional Afrika vol. 13 issue 3 2023
African Journal of Emergency Medicine
Analgesia use in trauma patients at a university teaching hospital in Kigali, Rwanda

Jurnal Internasional Afrika vol. 13 issue 3 2023
African Journal of Emergency Medicine
Analgesia use in trauma patients at a university teaching hospital in Kigali, Rwanda

Trauma Pain management Analgesia Rwanda

Introduction: While trends in analgesia have been identified in high-income countries, little research exists re- garding analgesia administration in low- and middle-income countries (LMIC). This study evaluates analgesia administration and clinical characteristics among patients seeking emergency injury care at University Teaching Hospital-Kigali in Kigali, Rwanda. Methods: This retrospective, cross-sectional study utilized a random sample of emergency center (EC) cases ac- crued between July 2015 and June 2016. Data was extracted from the medical record for patients who had an injury and were ≥ 15 years of age. Injury-related EC visits were identified by presenting complaint or final dis- charge diagnosis. Sociodemographic information, injury mechanism and type, and analgesic medications ordered and administered were analyzed. Results: Of the 3,609 random cases, 1,329 met eligibility and were analyzed. The study population was predom- inantly male (72%) with a median age of 32 years and range between 15 and 81 years. In the studied sample, 728 (54.8%) were treated with analgesia in the EC. In unadjusted logistic regression, only age was not a signifi- cant predictor of receiving pain medication and was excluded from the adjusted analysis. In the adjusted model, all predictors remained significant, with being male, having at least one severe injury, and road traffic accident (RTA) as injury mechanism being significant predictors of analgesia administration. Conclusion: In the study setting of injured patients in Rwanda, being male, involved in RTA or having more than one serious injury was associated with higher odds of receiving pain medication. Approximately half of the patients with traumatic injuries received pain medications, predominantly opioids with no factors predicting whether a patient would receive opioids versus other medications. Further research on implementation of pain guidelines and drug shortages is warranted to improve pain management for injured patients in the LMIC setting.

Jean Muragizi , Mindi Guptill , Bogdan G. Dumitriu , Michael B. Henry, Adam R. Aluisio , Jean Paul Nzabandora , Appolinaire Manirafasha , Janette Baird , Katelyn Morretti , Naz Karim

www.elsevier.com/locate/afjem

elsevier

11 May 2023

peri irawan

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