Pain should be treated with effective medications, the various opioids being best suited for this purpose. Their effect starts quickly and the power is enough to alleviate the pain of pain. There is, however, little use of NSAIDs in emergency care due to their limited efficacy and adverse effects. The most feared adverse reaction of opioids is a respiratory depression that can be prevented by administering a small amount of opioid at a time until a pain relief is achieved. Primary care uses both long and short-acting opioids, each of which has its own indications. A pain in the conscious patient should always be treated; there is no reason to refrain from treating pain.
Pain is the most common condition reported by patients in primary care. Unfortunately, just under a quarter of those hospitalized primary care patients feel they have enough pain relief (Goodacre 1996, Morgan-Jones 1996, Paris and Stewart 1998).
The reason for this is often the underestimation of pain experienced by a patient and the fear of nursing staff for the delivery of effective analgesics. Treatment of acute pain can effectively prevent some painful reactions caused by pain such as breathing surface and pulmonary dysfunction, sympathetic nerve stimulation and the resulting increase in blood pressure and pulse rate (Hedderich 1999). In addition, it may be possible to prevent chronic pain.
The same pain effect causes different reactions in different people. The reason for this may be cultural differences, past experiences of pain and learned behavior. The best pain indicator is the amount of pain that the patient has told himself. The most appropriate indicator for emergency care is the patient’s estimate on a scale of 1 to 10, with 1 of the lowest possible and 10 of the most imaginable pains. The estimate should be recorded in the patient’s medical report before and after the administration of the analgesic. In addition to the medication, good pain management includes a calm and patient attitude, thoughtful movements, and good injury and immobilization of the injury patient.
Although there is very little prospective studies on drug relief for primary care patients, the choice of analgesic should be based on medical evidence. The purpose of bullying is to provide rapid and effective relief of pain without any adverse effects. In addition, the medicine should be easy to administer. Unfortunately, a medicine that meets these requirements does not exist (Table 1).
The most opioid for ophthalmic painkillers, which are effective, fast-acting and well-used, are quite safe (Hedderich 1999). In addition to pain, opioids also relieve pain and anxiety of the patient. In contrast, NSAIDs are generally not suitable for primary care patients as analgesics. They are ineffective in hard pain and their effect starts pretty slowly. They also have side effects that can be considered dangerous for certain groups of patients.
They increase the leakage tendency that is detrimental to the injured person (Souter 1994). In addition, they impair renal blood flow and may cause renal impairment, especially in hypovoleemic patients (Souter et al. 1994, Hedderich 1999). They lower the bronchi, which prevents their use in asthma. It is to be remembered that metamizole (Litalgin) is included in this drug group. It should not be used at least in the aforementioned patient groups.
Paracetamol and its precursor (prodrug) propasetamol do not significantly increase the bleeding tendency and do not exacerbate renal failure and are suitable for asthma (Kivity et al. 1999, Mitic-Zlatkovic and Stefanovic 1999). Their effect, however, starts slower than opioids and is ineffective with severe pain, so giving them a first-aid treatment is rarely the case.