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Difficulties in Controlling Mobilization Pain Using a Standardized Patient-Controlled Analgesia Protocol in Burns
Östergötlands Läns Landsting, Sinnescentrum, Department of Anaesthesiology and Surgery UHL. Linköping University, Department of Medical and Health Sciences, Anesthesiology. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Medical and Health Sciences, Anesthesiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of Anaesthesiology and Intensive Care VHN.
Linköping University, Department of Clinical and Experimental Medicine, Burn Center. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of Plastic Surgery, Hand surgery UHL.
Linköping University, Department of Clinical and Experimental Medicine, Burn Center. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of Plastic Surgery, Hand surgery UHL. Östergötlands Läns Landsting, Sinnescentrum, Department of Anaesthesiology and Surgery UHL.
2011 (English)In: JOURNAL OF BURN CARE and RESEARCH, ISSN 1559-047X, Vol. 32, no 1, 166-171 p.Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to evaluate pain relief for patients with burns during rest and mobilization with morphine according to a standard protocol for patient-controlled analgesia (PCA). Eighteen patients with a mean (SD) burned TBSA% of 26 (20) were studied for 10 days. Using a numeric rating scale (NRS, 0 = no pain and 10 = unbearable pain), patients were asked to estimate their acceptable and worst experienced pain by specifying a number on a scale and at what point they would like additional analgesics. Patients were allowed free access to morphine with a PCA pump device. Bolus doses were set according to age, (100 - age)/24 = bolus dose (mg), and 6 minutes lockout time. Degrees of pain, morphine requirements, doses delivered and demanded, oral intake of food, and antiemetics given were used as endpoints. Acceptable pain (mean [SD]) was estimated to be 3.8 (1.3) on the NRS, and additional treatment was considered necessary at scores of 4.3 (1.6) or more. NRS at rest was 2.7 (2.2) and during mobilization 4.7 (2.6). Required mean morphine per day was 81 (15) mg, and the number of doses requested increased during the first 6 days after the burn. The authors found no correlation between dose of morphine required and any other variables. Background pain can be controlled adequately with a standard PCA protocol. During mobilization, the pain experienced was too intense, despite having the already high doses of morphine increased. The present protocol must be refined further to provide analgesia adequate to cover mobilization as well.

Place, publisher, year, edition, pages
Lippincott Williams andamp; Wilkins , 2011. Vol. 32, no 1, 166-171 p.
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Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-66135DOI: 10.1097/BCR.0b013e31820334e5ISI: 000285996000029OAI: oai:DiVA.org:liu-66135DiVA: diva2:401942
Note
Original Publication: Andreas Nilsson, Sigga Kalman, Anders Arvidsson and Folke Sjöberg, Difficulties in Controlling Mobilization Pain Using a Standardized Patient-Controlled Analgesia Protocol in Burns, 2011, JOURNAL OF BURN CARE and RESEARCH, (32), 1, 166-171. http://dx.doi.org/10.1097/BCR.0b013e31820334e5 Copyright: Lippincott Williams & Wilkins http://www.lww.com/Available from: 2011-03-04 Created: 2011-03-04 Last updated: 2012-03-27Bibliographically approved

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Nilsson, AndreasKalman, SiggaSjöberg, Folke
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Department of Anaesthesiology and Surgery UHLAnesthesiologyFaculty of Health SciencesDepartment of Anaesthesiology and Intensive Care VHNBurn CenterDepartment of Plastic Surgery, Hand surgery UHL
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