Battlefield pain summit 2022: Expert consensus statements

Thomas R. Stark*, Nathan L. Davidson, Jeremy W. Cannon, Travis M. Polk, Stacy A. Shackelford, Jonathan D. Stallings, Andrew P. Cap, Stacy A. Shackelford, Chester C. Buckenmaier, Frank K. Butler, John L. Clifford, Craig G. Crandall, Angela Curell, Lilian Custodio, Sandeep T. Djangal, Robert T. Gerhardt, Grigsby Eric, Kenneth M. Hargreaves, Krista B. Highland, Crystal Hill-PryorEric F. Holt, Asma A. Khan, Robert L. Mabry, John C. Maitha, Brian C. McLean, Harold Montgomery, Peter Murray, Johnny W. Paul, Elaine D. Por, Jason L. Reed, Kathy L. Ryan, Margaux Salas, Natasha Sosanya, Jeffrey M. Tiede, John Vogel, Joseph C. Watso

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


BACKGROUND Battlefield pain occurs in combat casualties who experience 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 the current understanding of battlefield pain management, review the current state of battlefield pain research, and shape the direction of future research. METHODS On January 10 to 11, 2022, a hybrid in-person and virtual meeting hosted by the US Army Institute of Surgical Research defined research priorities for the Combat Casualty Care Research Program's Battlefield Pain research portfolio. Summit participants identified the following key focus areas under the umbrella of battlefield pain research: battlefield injury patterns; use of ketamine and nonopioid 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 were refined and rank ordered through a Delphi process. RESULTS Consensus was achieved on 7 statements 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 nonopioid analgesics represented a high priority. CONCLUSION The 7 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.

Original languageEnglish
Pages (from-to)S12-S15
JournalJournal of Trauma and Acute Care Surgery
Issue number2
StatePublished - 1 Aug 2022
Externally publishedYes


  • Combat casualty care
  • analgesia
  • forward surgical care
  • ketamine
  • military trauma


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