Results of a pilot multicenter genotype-based randomized placebo-controlled trial of propranolol to reduce pain after major thermal burn injury.
Journal Article (Journal Article;Multicenter Study)
BACKGROUND: Results of previous studies suggest that β-adrenoreceptor activation may augment pain, and that β-adrenoreceptor antagonists may be effective in reducing pain, particularly in individuals not homozygous for the catechol-O-methyltransferase (COMT) high-activity haplotype. MATERIALS AND METHODS: Consenting patients admitted for thermal burn injury at participating burn centers were genotyped; those who were not high-activity COMT homozygotes were randomized to propranolol 240 mg/d or placebo. Primary outcomes were study feasibility (consent rate, protocol completion rate) and pain scores on study days 5 to 19. Secondary outcomes assessed pain and posttraumatic stress disorder symptoms 6 weeks postinjury. RESULTS: Seventy-seven percent (61/79) of eligible patients were consented and genotyped, and 77% (47/61) were genotype eligible and randomized. Ninety-one percent (43/47) tolerated study drug and completed primary outcome assessments. In intention-to-treat and per-protocol analyses, patients randomized to propranolol had worse pain scores on study days 5 to 19. CONCLUSIONS: Genotype-specific pain medication interventions are feasible in hospitalized burn patients. Propranolol is unlikely to be a useful analgesic during the first few weeks after burn injury.
Full Text
Duke Authors
Cited Authors
- Orrey, DC; Halawa, OI; Bortsov, AV; Shupp, JW; Jones, SW; Haith, LR; Hoskins, JM; Jordan, MH; Bangdiwala, SI; Roane, BR; Platts-Mills, TF; Holmes, JH; Hwang, J; Cairns, BA; McLean, SA
Published Date
- January 2015
Published In
Volume / Issue
- 31 / 1
Start / End Page
- 21 - 29
PubMed ID
- 25084070
Pubmed Central ID
- PMC4260989
Electronic International Standard Serial Number (EISSN)
- 1536-5409
Digital Object Identifier (DOI)
- 10.1097/AJP.0000000000000086
Language
- eng
Conference Location
- United States