Sex-based differences in analgesic administration in trauma patients

Introduction: In recent years, significant progress has been achieved both in the management of traumatic injuries and in the field of analgesia, resulting in reduced mortality and disability. Pain management includes both pharmacological and non-pharmacological measures, with the pharmacological approach often based on the three-step analgesic ladder developed by the World Health Organization (WHO). Aim: To determine whether there is a difference in the application of pain therapy during the initial management of male and female patients following injury in prehospital settings. Material and Methods: A retrospective observational study was conducted, including patients of all ages who sustained traumatic injuries and were managed on-site by emergency medical service (EMS) teams. Results: The study included 2,028 patients with traumatic injuries managed by EMS teams in the prehospital settings, including 950 (46.84%) females and 1,078 (53.16%) males. The mean age of injured females was 60.54±24.04 years, and of males 46.27±23.86 years. Females most commonly sustained injuries due to ground-level falls (620, 65.26%), as did males (472, 43.78%). In both males and females, head injuries were the most frequent. Suspected fractures were present in 132 (13.89%) females and 113 (10.48%) males. During initial on-site management and transport, analgesic therapy was administered to 90 females (9.47%) and 71 males (6.59%). Males more frequently received tramadol and at higher doses compared to females. Conclusion: The results indicate that the use of analgesia in prehospital settings remains insufficient. A sex-based difference in therapeutic approach was identified, with analgesia more frequently administered to females, while males were more often treated with opioid analgesics and females with non-opioid analgesics.