Volume 44 Number 2 2007
Pages 179 — 194

Abstract - Pain and combat injuries in soldiers returning from Operations Enduring Freedom and Iraqi Freedom: Implications for research and practice

Michael E. Clark, PhD;1-2* Matthew J. Bair, MD, MS;3 Chester C. Buckenmaier III, MD;4 Ronald J. Gironda, PhD;1-2 Robyn L. Walker, PhD1

1James A. Haley Veterans' Hospital, Tampa, FL; 2University of South Florida, Tampa, FL; 3Center of Excellence on Implementing Evidence-Based Practice, Richard L. Roudebush Department of Veterans Affairs Medical Center, Indianapolis, IN; 4Department of Anesthesiology, Walter Reed Army Medical Center, Washington, DC

Abstract — Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) have resulted in a growing number of seriously injured soldiers who are evacuated to the United States for comprehensive medical care. Trauma-related pain is an almost universal problem among these war-injured soldiers, and several military and Department of Veterans Affairs initiatives have been implemented to enhance pain care across the continu-um of medical services. This article describes several innovative approaches for improving the pain care provided to OEF and OIF military personnel during acute stabilization, transport, medical-surgical treatment, and rehabilitation and presents summary data characterizing the soldiers, pain management services provided, and associated outcomes. We also identify some of the pain assessment, classification, and treatment challenges emerging from work with this population and provide recommendations for future research and practice priorities.

Key words: acute pain, chronic pain, combat injuries, pain assessment, polytrauma, postacute pain, regional anesthesia, rehabilitation, trauma, traumatic brain injury.

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