Wibbenmeyer et al., 2014 |
Patients older than 18 (n = 53) with a burn injury compromising at least 5% body surface area and a predicted hospitalization of 48 hours. |
Gabapentin |
Day 1: 1200 mg (only dose). |
Placebo |
Pain intensity according to Numeric Rating Scale: Average (SD) |
There is no difference in the pain intensity reported after procedure between groups |
Gabapentin is ineffective as an analgesic adjunct in the immediate postburn period, RCT |
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Day 2,3: 300 mg TID, 900 mg.day-1
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Group I (n = 27) 5.4 ± 2.5 |
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Day 4-7 of study: 600 mg TID 1800 mg Daily. |
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Group C (n = 26) 5.5 ± 2.5 |
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Day 8-11 of study: 800 mg TID 2400 mg Daily. |
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p= 0,57 |
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[Optional raising to 2400 if pain score continues at 4 in NPR scale] |
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Day 11 of study: 1200 mg TID 3600 mg Daily [Optional raising to 3600 if pain score continues at > 4 in NPR scale] |
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Jason Wasiak et al., 2011 |
Adult patients (n = 90) admitted to the Victorian Adult Burn Service, with a burn injury affecting between 3 and 55% body surface area. And that were taken to injury care procedures as in: Debridement ± change of dressings in within two days and analgesia was prescribed with opioids as part of the treatment |
Lidocaine |
Initial Dose: 1.5 mg.kg-1 (30 minutes post procedure) |
Saline solution 0.9% |
Pain intensity according to according to numeric scale (Numeric Rating Scale): Median (RIC) |
Mild increment in reported pain in lidocaine group |
Adjuvant use of intravenous lidocaine for procedural burn pain relief: a randomized double-blind, placebo-controlled, cross-over trial, RCT |
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Bolus: 0,5 mg.kg-1 (two boluses after initial dose every 5 minutes) |
Administered in equal volume, dose, and speed as lidocaine |
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Infusion: 2 mg.min-1 (during the duration of the changing of dressings) |
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Group I (n = 45) |
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Group C (n = 45) |
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1 (0-2) |
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1 (0-3) Change in NRS |
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Prakash et al., 2004 |
Adult patients (n = 60) with thermal burns of more than 20% body surface area and programmed to the change of dressings |
Fentanyl |
Initial dose: 1 µg.kg-1 (10 minutes before the procedure of every patient) Dose on demand of fentanyl divided in four groups: 10, 20, 30 and 40 µg |
PCA-fentanyl demand doses 10, 20, 30, and 40 µg. |
Size of demanded dose of fentanyl (µg) |
Optimal on demand dose of fentanyl controlled by the patient (PCA) was 30 µg (5-minute interval) after the initial dose of fentanyl 1 IV µg.kg-1
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Patient-Controlled Analgesia with Fentanyl for Burn Dressing Changes, RCT |
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Score VAS scale: average (SD) |
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Group 10 µg: 7.73 (1.33) |
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Group 20 µg: 7.20 (1.21) |
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Group 30 µg: 4.47 (0.83) |
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Group 40 µg: 3.90 (0.63) |
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P ≤ 0,05 |
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Lee JJ, et al., 1989 |
Adult male patients (n = 50) between 18-65 years hospitalized with second and third degree burns and taken to debridement of injuries |
Nalbuphine |
0,4 mg.kg-1
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Morphine 0,2 mg.kg-1
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Pain intensity nominal scale: none, mild, moderate, severe |
Nalbuphine and morphine have a comparable analgesic efficacy |
Effectiveness of nalbuphine for relief of burn debridement pain, RCT |
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Nalbuphine (n = 25) Morphine (n = 25) |
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p 10 minutes after treatment |
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2,6 ± 0,2 2,4 ± 0,1 > 0,05 |
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Pain intensity VAS scale: 0 = none, 10 = severe |
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Nalbuphine (n = 25) Morphine (n = 25) |
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p 10 minutes after treatment 4,5 ± 0,6 3,4 ± 0,5. > 0,05 |
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Kundra et al., 2013 |
Adult hospitalized patients (n = 120) with a burn injury compromising 20% to 50% body Surface area. |
Ketamine (Group K) |
5 mg.kg-1
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Dexmedetomidine 4 mcg.kg-1 (Grupo D) |
Pain intensity evaluated with visual analog scale: average (SD) Grupo K (n = 60): 2,6 ± 0,6 cm |
VAS score was improved in 67% in group K and 44% in group D from baseline values. VAS scores improved significantly in group K vs group D in every time interval, P< 0.05 |
Oral ketamine and dexmedetomidine in adults’ burn wound dressing—A randomized double-blind cross over study, RCT |
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Grupo D (n = 60): 3,8 ± 0,8 cm |
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M.L. Borland et al., 2005 |
Children with burn injury aged up to 15 years (n = 24). |
Intranasal fentanyl |
1,4 µg.Kg-1
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Oral morphine 1 mg.kg-1
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Intranasal fentanyl |
Intranasal fentanyl is an adequate analgesic agent used in changes of dressings for pediatric burns, by itself or in combination with oral morphine as a titratable agent. |
Intranasal fentanyl is an equivalent analgesic to oral morphine in paediatric burns patients for dressing changes: a randomized double blind crossover study, RCT |
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Group A |
Baseline 0 (0-1) |
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(Day 1: oral morphine + intranasal placebo |
1 (0-1.3) |
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Day 2: oral placebo + intranasal fentanyl) |
0.31 |
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Group B |
Pre-procedure |
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(Day 1: Intranasal fentanyl + oral placebo |
4.3 (0-6) |
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Day 2: oral morphine + intranasal placebo) |
2 (1-3.1) |
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0.47 |
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Post procedure |
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0 (0-4) a |
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1.5 (0.8-2.5) |
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0.45 |
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Data are presented as median and interquartile range |
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a = lost values for a patient |
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b = lost values for two patients |
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