Ketamine and midazolam delivered by patient-controlled analgesia in relieving pain associated with burns dressings.
BACKGROUND
A study involving the use of a mixture of ketamine and midazolam delivered via patient-controlled analgesia (PCA) device was trialed to assess its effectiveness in reducing pain associated with repeated burns dressings in an adult population.


METHODS
Patients undergoing burns dressings changes were given a PCA device of ketamine and midazolam to use during the procedure. The aims were to investigate the efficacy of the device and to ascertain what (if any) adverse effects were associated with its use.


RESULTS
During the trial period, 44 patients who underwent 95 separate procedures were enrolled. The effectiveness of the device was rated (out of 10) by both staff and patients with the mean scores being 8.47 and 8.50, respectively. In all but 1 case, the proposed procedure was carried out successfully. Thirteen patients reported a total of 23 adverse effects, with hallucinations (11) being the most common.


CONCLUSIONS
The use of ketamine/midazolam delivered by PCA was shown to be an effective means of pain control during burns dressings as assessed by both staff and patients. The incidence of adverse events was low.
MacPherson
Ross D
RD
Department of Anaesthesia and Pain Management, Royal North Shore Hospital, Pacific Highway, St Leonards NSW, Australia. rmacpher@nsccahs.health.nsw.gov.au
Woods
David
D
Penfold
Joanna
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D016058:Analgesia, Patient-Controlled / Q000379:methods*; D000700:Analgesics / Q000008:administration & dosage / Q000009:adverse effects; D001458:Bandages / Q000009:adverse effects*; D002056:Burns / Q000150:complications / Q000628:therapy*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000009:adverse effects; D007649:Ketamine / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D008874:Midazolam / Q000008:administration & dosage* / Q000009:adverse effects; D008875:Middle Aged; D010146:Pain / Q000209:etiology* / Q000517:prevention & control*; D010147:Pain Measurement / Q000187:drug effects; D016896:Treatment Outcome
D000700:Analgesics; D006993:Hypnotics and Sedatives; D007649:Ketamine; D008874:Midazolam