Analgesic use in contemporary burn practice: Applications to burn mass casualty incident planning

Burns. 2020 Feb;46(1):90-96. doi: 10.1016/j.burns.2019.02.018. Epub 2019 Dec 16.

Abstract

Background: Determining the amount of analgesics required will help burn centers improve their ability to plan for a burn mass casualty incident (BMCI). We sought to quantify the amount of analgesics needed in an inpatient burn population. We hoped that assessing the analgesic use in daily burn care practice will potentially help estimate opioid needs in a burn mass casualty incident (BMCI).

Methods: We included patients with burns covering equal to or less than 30% total body surface area (TBSA), admitted from spring 2013 to spring 2015. Patient records were reviewed for analgesics and adjuncts, pain scores, age and TBSA. The doses of the different opioids administered were converted into morphine equivalent doses (MED).

Results: We enrolled 141 acute burn survivors with a mean TBSA of 8.2±0.6%. The lowest daily average MED per person was 24.6±2.0mg MED, recorded on the day of injury. The daily average MED per person increased until it peaked at 52.5±5.6mg MED at day 8 post-burn. Then, it declined to 24.6±3.4mg MED by day 14. Bivariate regression analysis of average MED by TBSA showed a significant positive correlation (p<0.001). The analysis of average MED by age showed a significant negative correlation (p<0001).

Conclusion: Our study quantified opioid requirements in an inpatient burn population and identified TBSA (positively) and age (negatively) as significant predictors.

Keywords: Analgesic; Burn; Burn mass casualty incident; Disaster plan; Opioid; Surge capacity.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Analgesics, Non-Narcotic / therapeutic use*
  • Analgesics, Opioid / supply & distribution
  • Analgesics, Opioid / therapeutic use*
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Anticonvulsants / therapeutic use
  • Antidepressive Agents / therapeutic use
  • Body Surface Area
  • Burn Units
  • Burns / pathology
  • Burns / therapy*
  • Disaster Planning*
  • Female
  • Histamine Antagonists / therapeutic use
  • Humans
  • Hypnotics and Sedatives / therapeutic use
  • Male
  • Mass Casualty Incidents*
  • Middle Aged
  • Pain Management / methods*
  • Surge Capacity
  • Young Adult

Substances

  • Analgesics, Non-Narcotic
  • Analgesics, Opioid
  • Anti-Inflammatory Agents, Non-Steroidal
  • Anticonvulsants
  • Antidepressive Agents
  • Histamine Antagonists
  • Hypnotics and Sedatives