Dr Rachel Khoo1, Dr Annette Camer-Pesci1, Dr Helen Douglas1, Prof Fiona Wood1, Dr Suzanne Rea1
1State Adult Burns Unit, Fiona Stanley Hospital, 11 Robin Warren Dr, Murdoch WA 6150
Background:Burn wound pain management is challenging and complex. Traditionally, the use of opioid analgesia has been the mainstay approach. However, the use of such analgesia is not without side-effects and risks. A nationwide restriction on over-the-counter purchase of codeine products was recently introduced due to widespread concerns regarding risks of addiction and abuse. In contrast, the use of non-opioid analgesia, physiotherapy, oedema control, and non-pharmacological techniques have increased amongst practices. Most of our smaller injuries are discharged on Paracetamol and Celecoxib; with the use of Pregabalin and Tramadol considered on a case-by-case basis. We wished to discover what analgesia our inpatients with smaller burn injuries (<10% TBSA) were taking post-discharge.
Methods:Looking at a cohort of inpatients with burn injuries (<10% TBSA), a 4-week prospective community-based telephone survey of discharged inpatients was carried out. Questions regarding analgesia requirements, pain scores and adequacy of pain control in the acute period were assessed on discharge, at 48hrs, one week, and at six weeks post-discharge.
Discussion: Adequate pain control in a burn patient is paramount for their journey to recovery. The increasing problems seen with painkiller addiction, has led us to question whether we are over or under prescribing such analgesia and what our population requirement is in the smaller burn injury. In assessing our practice, we aim to discover the level of adequate analgesia to control patient pain, allow therapy, and a return to activity vital to their rehabilitation.
Rachel is currently a service registrar at Royal Perth Hospital. Her interests lie in the pathophysiology of wound healing, anatomy, and rock climbing.