Acute pain management in a multi-site trauma patient

Clinical management is often difficult in the setting of multi-site trauma such as in the case of MVA, which is especially compounded in the setting of polysubstance abuse. This often results in patient with poor pain tolerance requiring escalating doses of opioid therapy, which creates a vicious cycle. The use of peripheral nerve blocks (PNB) have been shown to decrease overall opioid consumption and can be used effectively to manage postoperative pain in this patient population. Our case aims to highlight the importance of PNBs as part of a multimodal approach to pain management in patients with polytrauma in the setting of polysubstance abuse.