Acute @entity158 management of XXXX with multiple @entity174 .

@entity1 @entity174 @entity130 @entity1337 @entity651 @entity764 @entity1576 @entity158 @entity616
BACKGROUND: @entity174 causes severe @entity158 that can seriously compromise respiratory mechanics and exacerbate underlying @entity651 and pre-existing @entity1576 , predisposing to @entity1576 . The cornerstone of management is early institution of effective @entity158 relief, the subject of this review. METHODS: A MEDLINE search was conducted for the years 1966 through and up to December 2002 for @entity1 studies written in English using the keywords " @entity174 ", " @entity1337 ", "blunt @entity764 ", " @entity764 ". The reference list of key articles was also searched for relevant articles. The various analgesic techniques used in @entity1 with multiple @entity174 were summarized. RESULTS: Analgesia could be provided using systemic opioids, transcutaneous electrical nerve stimulation or non steroidal anti-inflammatory drugs. Alternatively, regional analgesic techniques such as @entity616 , epidural @entity1337 , intrathecal opioids, interpleural @entity1337 and thoracic @entity616 have been used effectively. Although invasive, in general, regional blocks tend to be more effective than systemic opioids, and produce less systemic side effects. CONCLUSION: Based on current evidence it is difficult to recommend a single method that can be safely and effectively used for @entity1337 in all circumstances in @entity1 with multiple @entity174 . By understanding the strengths and weaknesses of each analgesic technique, the clinician can weigh the risks and benefits and individualize @entity158 management based on the clinical setting and the extent of @entity130 .
