Pain Management Interventions in Military Medicine: State-of-the-Art Pain Management Modalities Used by Physicians and Nurses in Ministry of Defense Hospitals for Trauma Incurred During Combat

Mudhaya, Rawan Ali; Alhakami, Raneem Ali; Alsulami, Wejdan Fare; Aladwani, Maryam Ibrahim; Alsamti, Anwar Mohammed; Almutairi, Alhanouf Obaid; Sufyani, Samah Dawood; Aldarbashi, Amani Essa; ALSHAMRANI, HAZZAA SALEH HAZZAA; ALZAHRANI, SALEH AHMED SALEH; ALMUTAIRI, ATALLAH MUTHAYKIR

doi:10.21608/jmals.2025.454697

Pain Management Interventions in Military Medicine: State-of-the-Art Pain Management Modalities Used by Physicians and Nurses in Ministry of Defense Hospitals for Trauma Incurred During Combat

Document Type : Original Article

Authors

¹ King Fahad Armed Forces Hospital, Jeddah, Nursing Specialist, Saudi Arabia

² King Fahd Armed Forces Hospital – Ministry of Defense, Jeddah, bachelor’s degree in nursing, Saudi Arabia

³ General Directorate for Health Services, Ministry of Defense, Riyadh, Bachelor of Science in Nursing, Nursing Specialist, Saudi Arabia

⁴ King Fahad Armed Forces Hospital, Jeddah, Bachelor's, Nursing specialist, Saudi Arabia

⁵ Nursing, Armed forces hospital -dhahran, Saudi Arabia

⁶ Armed Forces, Saudi Arabia

10.21608/jmals.2025.454697

Abstract

Background: Trauma incurred in ongoing conflicts, including blast trauma and polytrauma, has elevated chronic pain rates, with up to 60% of injured personnel, and is a factor in the heightened post-traumatic stress disorder (PTSD) and reduced operational readiness. Ministry of Defense (MoD) healthcare systems face specific difficulties in the delivery of sophisticated pain care within austere environments. Aim: This review synthesizes 2020–2025 evidence on pain management strategies used by physicians and nurses in MoD settings for combat injury, with the intention to evaluate efficacy, identify barriers, and inform standardized protocols. Methods: A narrative synthesis of peer-reviewed articles in PubMed, Embase, and CINAHL was conducted, prioritizing multimodal strategies (pharmacological, regional anesthesia, complementary integrative health [CIH], rehabilitation). Studies were evaluated using the Mixed Methods Appraisal Tool (2020). Results: Multimodal therapies, including ketamine infusions (50–70% acute relief), peripheral nerve blocks (74% evacuation relief), and CIH (0.44 SD pain reduction), are more effective than unimodal methods. Nurse-physician teams enhance efficiency, but logistical challenges, opioid stigma, and resource disparities hinder implementation.
Conclusion: Combined pain services reduce opioid dependence and improve outcomes, necessitating more training, tele-CIH expansion, and NATO collaboration to surmount challenges and deliver equitable care.

Keywords