Department of Pharmacy Services, University of California, Davis.
J Burn Care Res. 2020 Sep 23;41(5):963-966. doi: 10.1093/jbcr/iraa088.
Analgesia in burn patients is challenging given the complexity of burn pain and prolonged need beyond hospital admission. Given the risks of opioids, the impact of multimodal analgesia postdischarge needs to be further elucidated in this population. This retrospective, single-center cohort study evaluated adult burn patients who were consecutively admitted to the burn service with at least 10% total body surface area burned and subsequently followed in the burn clinic between February 2015 and September 2018. Subjects were separated into two cohorts based on discharge pain regimens: multimodal and nonmultimodal. The primary outcome was the change in opioid requirements (measured in oral morphine equivalents) between discharge and first follow-up interval. Secondary outcomes included the classes of multimodal agents utilized and a comparison of opioid requirements between the last 24 hours of admission and discharge. A total of 152 patients were included for analysis, 76 in the multimodal cohort and 76 in the nonmultimodal cohort. The multimodal cohort was noted to have increased total body surface area burned and prolonged number of days spent in the intensive care unit at baseline; however, the multimodal cohort exhibited a more significant decrease in opioid requirements from discharge to first follow-up interval when compared with the nonmultimodal cohort (106.6 vs 75.4 mg, P = .039).
由于烧伤疼痛的复杂性和住院后长时间的需要，烧伤患者的镇痛具有挑战性。鉴于阿片类药物的风险，需要进一步阐明这种人群出院后多模式镇痛的影响。这项回顾性、单中心队列研究评估了 2015 年 2 月至 2018 年 9 月期间连续入住烧伤科的至少 10%总体表面积烧伤的成年烧伤患者，并随后在烧伤诊所进行随访。受试者根据出院时的疼痛治疗方案分为多模式和非多模式两组。主要结局是出院和首次随访间隔期间阿片类药物需求（以口服吗啡当量衡量）的变化。次要结局包括多模式药物的类别以及入院最后 24 小时和出院时阿片类药物需求的比较。共有 152 例患者纳入分析，其中多模式组 76 例，非多模式组 76 例。多模式组的总体表面积烧伤更大，入住重症监护病房的天数也更长；然而，与非多模式组相比，多模式组从出院到首次随访间隔的阿片类药物需求下降更为显著（106.6 与 75.4mg，P=0.039）。
