Treatment of postoperative pain for burn patients with intravenous analgesia in continuous perfusion using elastomeric infusors.
BACKGROUND
Postoperative pain after surgery with patients suffering from burns tends to be moderate or severe, and its treatment requires a combination of high-strength analgesics (opioids) with others having different action mechanisms according to the concept of multimodal analgesia.


OBJECTIVE
In this article we propose the use of continuous intravenous analgesia with morphine using elastomeric infusors at fixed dose for the treatment of this kind of pain. An evaluation is made of its analgesic efficacy, side effects and level of satisfaction.


METHODS
A study was made of 17 burn patients operated on in our unit who received continuous intravenous analgesia during the postoperative period, with morphine at 1mg/h, using elastomeric infusors for a period of 24h. Its analgesic efficacy was analysed using the visual analogical scale (VAS) at different moments; side effects and the level of acceptance by the patient was also evaluated.


RESULTS
The results confirm a good analgesic effect after 2h from starting perfusion (VAS < 3). The side effects reveal a similar or lesser incidence to the use of morphine in bolus or using the PCA system, and in no cases did they require treatment to be halted. The level of acceptance of the procedure by patients was good.


CONCLUSIONS
This method reveals a high level of analgesic efficacy in the postoperative period with burn patients in this study. However, it is important to note the lower results obtained in the first hours of perfusion, and proposing a heavy initial dose of analgesics when starting perfusion. This is presented as an efficient analgesic method that is easy to apply, has a low cost, and the possibility of extending its indications to ambulatory treatment.
García Barreiro
J
J
Plastic Surgery and Burn Service, Juan Canalejo University Hospital Complex, Xubias de Arriba S/N, Pol. Adormideras Ed., Torremar de S. Amaro P-18, 15002 La Coruña, Spain. jgarciabarr@mundo-r.com
Rodriguez
A
A
Cal
M
M
Alvarez
A
A
Martelo Villar
F
F
D000293:Adolescent; D000328:Adult; D000368:Aged; D016058:Analgesia, Patient-Controlled / Q000379:methods; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects; D001794:Blood Pressure / Q000502:physiology; D002056:Burns / Q000503:physiopathology / Q000601:surgery*; D020724:Elastomers; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage* / Q000009:adverse effects; D010147:Pain Measurement / Q000379:methods; D010149:Postoperative Pain / Q000188:drug therapy* / Q000503:physiopathology; D017060:Patient Satisfaction; D011182:Postoperative Care / Q000379:methods
D000701:Analgesics, Opioid; D020724:Elastomers; D009020:Morphine