Acute pain and analgesic prescribing in trauma inpatients at a tertiary hospital: A cross-sectional study

Abstract

Background: Acute pain after trauma remains common and is often not well controlled. This study described pain intensity at inpatient assessment and the analgesics prescribed to adults admitted after traumatic injury to a tertiary academic trauma unit.
Methods: This was a cross-sectional observational study of adult trauma patients admitted to the general trauma ward. Data collected included demographics, comorbidities, current pain intensity on the Numerical Rating Scale, psychological symptom scores, substance-use risk and prescribed analgesics. Reported pain severity at admission was ascertained from the patient. Categorical data were summarised descriptively, and exploratory associations were assessed using chi-squared or Fisher’s exact test, as appropriate.
Results: The study included 143 participants, of whom 81.1% (n = 116) were male, and 33.6% (n = 48) had penetrating injury. At interview, 62.9% (n = 90) reported moderate to severe pain. Paracetamol with tramadol was the most commonly prescribed regimen across pain categories. No statistically significant association was observed between current pain category and hypertension, diabetes mellitus, human immunodeficiency virus status, anxiety symptoms, depressive symptoms, or substance-use risk.
Conclusion: Most participants were still experiencing moderate to severe pain at the time of assessment despite prescribed analgesia. Paracetamol with tramadol remained the dominant regimen, with limited visible change across pain categories.
Contribution: This study provides an inpatient, cross-sectional account of persistent pain after trauma and the analgesics prescribed in a South African tertiary trauma service and may inform local quality-improvement efforts in trauma pain management.