Citation

Kim DE, Pruskowski KA, Ainsworth CR, Linsenbardt HR, Rizzo JA, Cancio LC. J. Burn Care Res. 2019; ePub(ePub): ePub.

Affiliation

U.S. Army Institute of Surgical Research, JBSA Fort Sam Houston, TX.

Copyright

(Copyright © 2019, American Burn Association, Publisher Lippincott Williams and Wilkins)

DOI

10.1093/jbcr/irz111

PMID

31259369

Abstract

Opioids are the mainstay of pain management after burn injury. The United States currently faces an epidemic of opioid overuse and abuse, while simultaneously experiencing a nationwide shortage of intravenous narcotics. Adjunctive pain management therapies must be sought and utilized to reduce the use of opioids in burn care to prevent the long-term negative effects of these medications and to minimize the dependence on opioids for analgesia. The purpose of this review was to identify literature on adjunctive pain management therapies that have been demonstrated to reduce pain severity or opioid consumption in adult burn patients. Three databases were searched for prospective studies, randomized controlled trials, and systematic reviews that evaluated adjunctive pain management strategies published between 2008 and 2019 in adult burn patients. Forty-six studies were analyzed, including 24 randomized control trials, six crossover trials, and ten systematic reviews. Various adjunctive pain management therapies showed statistically significant reduction in pain severity. Only one randomized control trial on music therapy for acute background pain showed a reduction in opioid use. One cohort study on hypnosis demonstrated reduced opioid use compared with historical controls. We recommend the development of individualized analgesic regimens with the incorporation of adjunctive therapies in order to improve burn pain management in the midst of an abuse crisis and concomitant national opioid shortage.

Published by Oxford University Press on behalf of the American Burn Association 2019. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Language: en

Keywords

Pain management; burns; non-opioid treatment; non-pharmacologic therapy; opioid tolerance; opioids abuse; systematic review