The Newest Battlefield Opioid, Sublingual Sufentanil: A Proposal to Refine Opioid Usage in the U.S. Military

Wilderness Medical Society Clinical Practice Guidelines for the Treatment of Acute Pain in Austere Environments: 2024 Update

The Wilderness Medical Society (WMS) convened an expert panel to develop evidence-based guidelines for the management of pain in austere environments. Recommendations are graded based on the quality of supporting evidence as defined by criteria put forth by the American College of Chest Physicians. This is an update of the 2014 version of the "WMS Practice Guidelines for the Treatment of Acute Pain in Remote Environments" published in Wilderness & Environmental Medicine 2014; 25:41-49.

Battlefield Pain Summit 2022: Expert Consensus Statements

BACKGROUND

Battlefield pain occurs in combat casualties who suffer multiple severe injuries The nature of battlefield scenarios requires a distinct approach to battlefield pain research. A Battlefield Pain Summit was thus convened to identify shortcomings in current understanding of battlefield pain management, review the current state of battlefield pain research, and shape the direction of future research.

METHODS

On 10-11 January 2022, a hybrid in-person and virtual meeting hosted by the United States Army Institute of Surgical Research (USAISR) defined research priorities for the Combat Casualty Care Research Program's Battlefield Pain research portfolio. Summit participants identified key focus areas under the umbrella of battlefield pain research: battlefield injury patterns; use of ketamine and non-opioid analgesics; analgesic delivery systems; the impact of analgesia on performance, cognition, and survival; training methods; battlefield regional anesthesia; and research models. Preliminary statements presented during the summit refined and rank ordered through a Delphi process.

RESULTS

A total of seven statements achieved consensus addressing ideal analgesic properties, delivery systems, operational performance concerns, and pain training. Ketamine was identified as safe and effective for battlefield use, and further research into non-opioid analgesics represented a high priority.

CONCLUSIONS

The seven consensus statements that emerged from this Battlefield Pain Summit serve as a template to define the near-term research priorities for military-specific battlefield pain research.

A Review of Sublingual Sufentanil Tablet (SST) and its Utility as an Analgesic Agent for Pain Procedures

Purpose of Review

Recent Findings

Summary