JNMA I VOL 52 I NO. 5 I ISSUE 189 I JAN-MAR, 2013 224 Use of Analgesia in an Emergency Department Rabin Bhandari, 1 Gyanendra Malla, 1 Indrajit Prasad Mahato, 1 Pramendra Gupta 1 1 Department of General Practice and Emergency, BP Koirala Institute of Health Sciences, Dharan, Nepal. ABSTRACT Introduction: Pain is a common presentation to the emergency department but often overlooked with little research done on the topic in Nepal. We did an observational retrospective study on 301 patients in the emergency ward of BP Koirala Institute of Health Sciences with the objective of finding the practice of analgesia. The specific focus was on the time to analgesia, drugs for analgesia and method of pain assessment. Methods: Case file analysis of patients discharged home after presenting with pain was performed. Time to analgesia and other factors were analyzed with descriptive statistics. Results: Diclofenac injection intramuscular (80%) was the commonest analgesic used. Assessment methods and record keeping were poor. Pain in the abdomen was the commonest. The median time to analgesia from triage was 45 minutes (IQR 30 to 80) and the median time to analgesia from doctor evaluation was 40 minutes (IQR 20 to 70). Conclusions: Time to analgesia from triage and doctors assessment in our set up is comparable to others. The quality of documentation is poor. Problems with pain identification and assessment may lead to inadequate analgesia so reinforcing the use of pain descriptor at triage itself with pain score would be helpful in adopting a protocol based management of pain. _______________________________________________________________________________________ Keywords: analgesia; emergency; Nepal. _______________________________________________________________________________________ INTRODUCTION Pain is a common presentation to the emergency department (ED). 1,2 We have a great responsibility to relieve pain by all possible appropriate means in a timely, efficient and effective manner through the full spectrum of pain. 2 The simple regimens, employing inexpensive drugs are often not followed due to inadequate healthcare systems. 3 Moreover, pain management may receive less importance due to burden of other significant disease. Many studies on pain management have focused on time to analgesia, barriers to effective analgesia and on the methods to reduce time to analgesia in emergency but there still seems to be room for improvement. A study showed that even with triage systems that consider pain as a determinant, the time to analgesia is still high. 4 The objectives of the study were to identify the drugs used for analgesia, time to analgesia and associated factors that might influence these and to find out the assessment methods used for pain. ______________________________________ Correspondence: Dr. Rabin Bhandari, Department of GP and EM, BPKIHS, Dharan, Nepal. Email:bhandari529@yahoo.com. CC S BY NC OPEN ACCESS ORIGINAL ARTICLE J Nepal Med Assoc 2013;52(189):224-8