Date of Award

January 2024

Document Type

Thesis

Degree Name

Medical Doctor (MD)

Department

Medicine

First Advisor

Nalini Vadivelu

Abstract

Facial trauma presents many unique challenges to appropriate pain management and there currently exists no standardized protocols for the management of pain associated with facial traumas. This narrative review aims to review the evidence of the use of opioids, acetaminophen, non-steroidal anti-inflammatory drugs, corticosteroids, ketamine, and local and regional anesthesia in facial trauma and related settings. With this evidence, this review aims to formulate guidance and recommendations for clinicians developing multimodal analgesic plans for pain in facial traumas.

Medline, Scopus, Cochrane Reviews, and Google Scholar were searched for scientific studies investigating the safety and efficacy of various analgesic agents in the management of post-operative pain, acute facial pain, pain from traumas, and facial trauma pain. Data was extracted from selected studies and synthesized into this review.

There is little research pertaining specifically to the use of these analgesic agents in facial trauma, mostly due to the fact the pain is often neglected in these studies. There is much evidence supporting the efficacy of these analgesic agents in other settings, including in related settings such as perioperatively and in traumas.

There may be a role for the various analgesic agents included in this study for pain management in facial trauma, though the safety and efficacy of certain agents in this setting still needs to be investigated. More prospective studies and randomized trials are needed to investigate the efficacy of various analgesic agents for acute facial pain and facial trauma, and pain needs to become a core reporting component in studies on facial trauma.

Comments

This thesis is restricted to Yale network users only. This thesis is permanently embargoed from public release.

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