Laima Juozapavičienė, Aurika Karbonskienė, Rytis Rimdeika


Background. Multimodal analgesia, which employs drug combinations that have different action mechanisms in order to improve pain relief, thereby minimizing dose dependent adverse effects, is recommended for burn pain management. Effective adjuncts for analgesia for burn patients still need to be developed. Aim: To evaluate the efficacy of gabapentin as an adjunct to morphine patient-controlled analgesia (IV-PCA) in pain treatment for burn patients during the 72-h period after injury. Methods. A prospective randomized controlled study. The pain treatment protocol was standardized with IV-PCA for all of the patients. The treatment patient group received 1200 mg per day of oral gabapentin. Morphine consumption, pain scores, incidence of adverse effects were recorded every 3 h (during the first 24 h after burn) and every 6 h thereafter or during the adverse event cases. Pain was assessed at rest and on movement: flexion in burn of extremity and cough in burn of torso. Results. During the study period, 53 severe burn patients (TBSA≥10%) were included (n=29 in the control group and n=24 in the treatment group). Morphine consumption on the three first days after a burn was significantly lower in the treatment group than in the control group (p<0.001). The total morphine consumption in the treatment group was 28% less than in the control group. The VAS scores were lower in the treatment group as well (p<0.001). No clinically significant adverse effects were documented. Conclusions. Our results indicate that 1200 mg of gabapentin may be useful as a safe analgesic adjunct in pain management for effective pain relief with an opioid sparing effect for burn patients during the 72-h period after injury.

Keyword(s): burn pain; morphine; gabapentin
DOI: 10.5200/sm-hs.2015.047
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