Brazilian Journal of Pain
https://brjp.org.br/article/doi/10.63231/2595-0118.202669-en
Brazilian Journal of Pain
Original Article

Analgesics prescription in upper limb trauma: a cross-sectional study

Prescrição de analgésicos em traumas do membro superior: um estudo transversal

Jéssica Xavier de Sá Morais; Bruna Caroline Pereira do Nascimento; Nicole Souto Ferreira; Luciane Fernanda Rodrigues Martinho Fernandes; Marco Aurélio Sertório Grecco; Denise Martineli Rossi

http://dx.doi.org/10.63231/2595-0118.202669-en BrJP, vol.9, e202669, 2026
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Abstract

BACKGROUND AND OBJECTIVES: Pain management in acute musculoskeletal trauma remains challenging, and uncertainty about how pain, psychosocial, and injury-related factors guide prescribing justifies investigation. The objective of this study was to verify if there was difference among analgesics prescription groups in hospitalized patients due to upper limb trauma regarding pain, psychosocial, sociodemographic and injury related variables. Secondly, the aim was to investigate the association among psychosocial variables.

METHODS: A cross-sectional study was conducted including 92 hospitalized adults within two weeks after acute upper limb trauma. Sociodemographic, clinical, and psychosocial data were collected. Patients were grouped according to prescribed pain drugs: dipyrone, dipyrone + tramadol, and dipyrone + morphine. Kruskal-Wallis test, Fisher’s Exact test and Spearman’s correlation test were used (α = 0.05).

RESULTS: Fractures were predominant in 80.2% of the sample, mostly due to traffic and work-related accidents, affecting primarily young men (77.2%). Patients that suffered domestic accidents were more frequently treated with dipyrone alone (p = 0.02), and traffic or work accidents received more often opioid-based combinations. No significant differences were observed among drug groups regarding pain, psychosocial, sociodemographic and other injured related variables. Moderate correlations were found among psychosocial variables.

CONCLUSION: Analgesic prescriptions for hospitalized patients with acute upper limb trauma differed only by cause of injury, with opioids more frequently prescribed for work- or traffic-related accidents. Psychosocial factors were interrelated, suggesting that prescribing decisions may reflect contextual perceptions of trauma severity rather than objective or self-reported pain indicators.

Keywords

Accidents; Analgesics; Arm trauma; Opioids; Pain; Upper extremity

Resumo

JUSTIFICATIVA E OBJETIVOS: O controle da dor em casos de traumas musculoesqueléticos agudos continua sendo um desafio, e a incerteza sobre como dor, fatores psicossociais e fatores relacionados à lesão orientam a prescrição justifica a investigação. O objetivo deste estudo foi verificar se há diferença entre os grupos de prescrição de fármacos para dor em pacientes hospitalizados devido a trauma no membro superior no que se refere a: dor, variáveis psicossociais e sociodemográficas e a própria lesão. Em segundo lugar, o objetivo foi investigar a associação entre as variáveis psicossociais.

MÉTODOS: Foi realizado um estudo transversal envolvendo 92 adultos hospitalizados nas duas semanas após um trauma agudo nos membros superiores. Foram coletados dados sociodemográficos, clínicos e psicossociais. Os pacientes foram agrupados de acordo com os fármacos prescritos para dor: dipirona, dipirona + tramadol e dipirona + morfina. Foram utilizados os testes de Kruskal-Wallis, exato de Fisher e correlação de Spearman (α = 0,05).

RESULTADOS: As fraturas foram predominantes em 80,2% da amostra, principalmente devido a acidentes de trânsito e de trabalho, afetando principalmente homens jovens (77,2%). Os pacientes que sofreram acidentes domésticos receberam com maior frequência tratamentos apenas com dipirona (p = 0,02), enquanto os casos de acidentes de trânsito ou de trabalho receberam mais combinações à base de opioides. Não foram observadas diferenças significativas entre os grupos de fármacos em relação à dor, variáveis psicossociais, sociodemográficas e outras variáveis relacionadas aos ferimentos. Foram encontradas correlações moderadas entre as variáveis psicossociais.

CONCLUSÃO: As prescrições de analgésicos para pacientes hospitalizados com traumatismo agudo nos membros superiores diferiram apenas pela causa da lesão, com opioides prescritos com mais frequência para acidentes de trabalho ou de trânsito. Os fatores psicossociais estavam inter-relacionados, sugerindo que as decisões de prescrição podem refletir percepções contextuais da gravidade do traumatismo, em vez de indicadores objetivos ou autorrelatados de dor.

Palavras-chave

Acidentes; Analgésicos; Dor; Opioides; Extremidade superior; Traumatismo do braço

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Submitted date:
11/11/2025

Accepted date:
02/26/2026

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