Management of Acute Pain of the War Wounded during Short and Long-distance Transport and "casevac"

In recent conflicts, advances in acute pain management have been pushed to the forefront of battlefield medical care. With dramatic improvements in battlefield resuscitation, mortality rates have significantly decreased, as a result significant numbers of patients sustaining severe polytraumatic injuries must now be transported from the site of injury and, eventually, to stateside military treatment facilities. A variety of transport platforms are utilized to facilitate this mission. Continued analgesia (especially regional anesthetic techniques) during transport is a critical component of battlefield care as it decreases suffering, minimizes the need for opioids and other sedating analgesics, facilitates earlier transport, and possibly plays a role in preventing chronic pain.