Satisfactory Analgesia Can Be Achieved Through a Simple Answer to a Simple Question

Satisfactory Analgesia Can Be Achieved Through a Simple Answer to a Simple Question

In a recent report in the June 11, 2015 issue of Annals of Emergency Medicine, researchers at the Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY studied whether the answer to a simple yes/no question would improve patient analgesia: “Do you want more pain medication?”

When non-elderly patients who presented at the Emergency Department were judged to be in severe pain requiring IV opioids by the attending physician, they were given 1cc of intravenous hydromorphone as a loading dose. Then, at 30 minute intervals, they were asked the question “do you want more pain medication?” Those answering yes to the question were given an additional 1cc hydromorphone IV.

The question was repeated every 30 minutes of all patients, up to four times. While some patients required O2 therapy, no adverse events were associated with the amount of hydromorphone received.

The study evaluated patient satisfaction, whether or not a patient received additional opioid pain medication at any 30 minute interval.

205 out of 207 patients reported satisfactory analgesia during the study period, representing 99% of the study group.

These people in severe pain achieved satisfactory analgesia by answering one simple question:

“Do you want more pain medication?”

When treating severe pain, perhaps this question should be asked more often.

Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article as per ICMJE conflict of interest guidelines (see The authors have stated that no such relationships exist.

Kurt W.G. Matthies is a writer who lives with the pain of severe chronic spine disease. He offers analysis and commentary on pain medicine and chronic pain perspectives for the National Pain Report.


Authored by: Kurt W.G. Matthies

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I find the yes no approach to reflect the silliness that is not uncommon in medical research. Just as in the movie The Life Of Brian they search for the source of Christs’ power in a shoe or gourd – so too do our scientists search for some magic substance or approach that will work for chronic pain. Our scientists are stuck when it comes to the wicked problem of chronic pain- as is indicated that no single biomarker has been reliably found for any pain condition.
Because medical science fails to recognize the wicked problem that pain is-they continue to apply failed and simple-minded solutions- just as they have been doing for a century.
Chronic pain is growing due to a failure of leadership, culture, and intelligence-but more importantly a stubborn attachment to solutions that don’t work well.

Pain Patient

What a novel concept! And they say that there is nothing new under the sun!