ABSTRACT
This chapter focuses on some of the causes of nonsurgical acute pain and some of the problems specific to acute pain management in these patients. Common to many of these situations is the presence of both nociceptive and neuropathic pain, requiring a mix of treatment strategies. In the initial stages after a burns injury, pain management using intravenous opioids is usually required, unless the burns are relatively minor. In patients who are hypovolemic, absorption of intermittent subcutaneous or intramuscular injections of opioid may be unreliable. Parenteral opioid administration may be continued once the patient is comfortable, for example, using patient-controlled analgesia. For less severe pain or after initial management of more severe pain, oral opioid analgesia may suffice. Neuropathic pain associated with spinal cord injury is classified as “at-level” and “below-level” and may be reported early after the injury, or later in the recovery and rehabilitation stages.
