Abstract

NAVARRO SUAY, R.  and  CASTILLEJO PEREZ, S.. Analgesia in the management of the combat casualty: Experience of the Spanish Medical Service. Sanid. Mil. [online]. 2012, vol.68, n.1, pp.08-16. ISSN 1887-8571.  https://dx.doi.org/10.4321/S1887-85712012000100002.

Antecedents and Objectives: The analgesia of the wounded has played a vital role in military medicine. Nowadays it still is a medical, tactical and logistical challenge in the integral management of the combat casualty. The objective of this study is to evaluate the homogeneity of the analgesic drugs used, starting point of the treatment, number and type of administration routes, as well as the type of anesthesia used in gunshot or explosive device casualties in the Spanish Role 2 in Herat (Afghanistan) between 2005 and 2008, in accordance with an anatomical injury severity score (NISS) of the injuries. Material and Methods: We carried out an observational, retrospective study with a sample of 256 patients. Results: The drugs most commonly used were the NSAIDs (73%) followed by major morphine derivatives (44%), adjuvants (29%), minor morphine derivatives (21 %), and ketamine (12%). In 61 % of the cases the analgesia was administered in the prehospital setting and in 31 % in the hospital. The most common administration route was intravenous (79%). In 75% of the cases only one administration route was obtained for analgesia. General anesthesia was the most common anesthetic procedure (32%). Conclusions: Analgesic treatment of the combat casualties studied was homogeneous in terms of drugs used and number and types of administration routes. However it was heterogeneous in reference to the chosen type of NSAIDs and initiation of analgesic drug administration.

Keywords : Analgesia; Combat; Pain; Spanish Medical Service; Afghanistan.

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