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Pain after earthquake

Chiara Angeletti1, Cristiana Guetti1*, Roberta Papola1, Emiliano Petrucci1, Maria Laura Ursini1, Alessandra Ciccozzi1, Francesca Masi2, Maria Rosaria Russo3, Salvatore Squarcione4, Antonella Paladini1, Joseph Pergolizzi567, Robert Taylor8, Giustino Varrassi9 and Franco Marinangeli1

Author Affiliations

1 Anaesthesiology, Intensive Care and Pain Medicine, Department of Health Sciences, University of L’Aquila, L’Aquila, Italy

2 Department of Civil Defense, Clinical Emergency Psychologist, Pisa, Italy

3 Hygiene and Preventive Medicine, University of L’Aquila, L’Aquila, Italy

4 Department of Civil Defense, Sanitary Risk Service, Rome, Italy

5 Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA

6 Department of Anesthesiology, Georgetown University School of Medicine, Washington, DC, USA

7 Department of Pharmacology, Temple University School of Medicine, Philadelphia, PA, USA

8 NEMA Research Inc., Naples, FL, USA

9 ASL Teramo, National Health Care Service, Teramo, Italy

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Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 2012, 20:43  doi:10.1186/1757-7241-20-43

Published: 29 June 2012



On 6 April 2009, at 03:32 local time, an Mw 6.3 earthquake hit the Abruzzi region of central Italy causing widespread damage in the City of L Aquila and its nearby villages. The earthquake caused 308 casualties and over 1,500 injuries, displaced more than 25,000 people and induced significant damage to more than 10,000 buildings in the L'Aquila region.


This observational retrospective study evaluated the prevalence and drug treatment of pain in the five weeks following the L'Aquila earthquake (April 6, 2009).


958 triage documents were analysed for patients pain severity, pain type, and treatment efficacy.


A third of pain patients reported pain with a prevalence of 34.6%. More than half of pain patients reported severe pain (58.8%). Analgesic agents were limited to available drugs: anti-inflammatory agents, paracetamol, and weak opioids. Reduction in verbal numerical pain scores within the first 24 hours after treatment was achieved with the medications at hand. Pain prevalence and characterization exhibited a biphasic pattern with acute pain syndromes owing to trauma occurring in the first 15 days after the earthquake; traumatic pain then decreased and re-surged at around week five, owing to rebuilding efforts. In the second through fourth week, reports of pain occurred mainly owing to relapses of chronic conditions.


This study indicates that pain is prevalent during natural disasters, may exhibit a discernible pattern over the weeks following the event, and current drug treatments in this region may be adequate for emergency situations.