Determination of the Effects of Change in Anxiety Level on Pain Perception in Patients who Present to Emergency Department due to Acute Pain: A Double Blind, Randomized, Controlled Trial

Abstract

Aim: The aim of this study is to determine the level of pain and anxiety, and to investigate the effect of standard analgesic treatment and additional anxiolytic treatment on pain and anxiety in patients who presented to the emergency department due to acute pain. Material and Methods: This is a prospective, randomized, controlled, double-blind study. As the study group received dexketoprofen trometamol plus midazolam, the control group received dexketoprofen trometamol alone. At 0th, 30th, 60thand 120th minutes of treatment, patients' pain and anxiety levels were measured. Patients' overall anxiety levels were measured. The primary outcome measure was the comparison of pain and anxiety change at 0-30 minutes. Results: The study was conducted with 90 patients in each group. The median pain change was 33.5 (IQR, 38) for the control group and 30 (IQR, 33) for the study group, and the mean difference was 3.5 (95% CI; -7.2 to 14.2). The median anxiety change was 9.5 (IQR, 41) for the control group and 20 (IQR, 40) for the study group, and the mean difference was -10.5 (95% CI; -24.37 to 3.37). The rescue therapy needed, treatment satisfaction and preference to the same treatment in the future were similar between the control and the study group, respectively (26.7% vs 40%, p=0.058; 64% vs 57%, p=0.770; 90% vs 89%, p=0.802). Conclusion: In patients who present to the emergency department due to an acute pain complaint, adding anxiolytic treatment to the analgesic treatment does not contribute to a reduction of pain and anxiety.