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Improvement of burn pain management through routine pain monitoring and pain management protocol
Authors:Hyeong Tae Yang  Giyeun Hur  In-Suk Kwak  Haejun Yim  Yong Suk Cho  Dohern Kim  Jun Hur  Jong Hyun Kim  Boung Chul Lee  Cheong Hoon Seo  Wook Chun
Institution:1. Department of Surgery, Burn Center, Hangang Sacred Heart Hospital, Hallym University Medical Center, 94-200, Youngdeungpo-dong, Youngdeungpo-gu, Seoul 150-719, Republic of Korea;2. Department of Plastic Surgery, Burn Center, Hangang Sacred Heart Hospital, Hallym University Medical Center, 94-200, Youngdeungpo-dong, Youngdeungpo-gu, Seoul 150-719, Republic of Korea;3. Department of Anesthesiology and Pain Medicine, Burn Center, Hangang Sacred Heart Hospital, Hallym University Medical Center, 94-200, Youngdeungpo-dong, Youngdeungpo-gu, Seoul 150-719, Republic of Korea;4. Department of Psychiatry, Burn Center, Hangang Sacred Heart Hospital, Hallym University Medical Center, 94-200, Youngdeungpo-dong, Youngdeungpo-gu, Seoul 150-719, Republic of Korea;5. Department of Rehabilitation Medicine, Hangang Sacred Heart Hospital, Hallym University Medical Center, 94-200, Youngdeungpo-dong, Youngdeungpo-gu, Seoul 150-719, Republic of Korea
Abstract:

Introduction

Pain management is an important aspect of burn management. We developed a routine pain monitoring system and pain management protocol for burn patients. The purpose of this study is to evaluate the effectiveness of our new pain management system.

Methods

From May 2011 to November 2011, the prospective study was performed with 107 burn patients. We performed control group (n = 58) data analysis and then developed the pain management protocol and monitoring system. Next, we applied our protocol to patients and performed protocol group (n = 49) data analysis, and compared this to control group data. Data analysis was performed using the Numeric Rating Scale (NRS) of background pain and procedural pain, Clinician-Administered PTSD Scale (CAPS), Hamilton Depression Rating Scale (HDRS), State-Trait Anxiety Inventory Scale (STAIS), and Holmes and Rahe Stress Scale (HRSS).

Results

The NRS of background pain for the protocol group was significantly decreased compared to the control group (2.8 ± 2.0 versus 3.9 ± 1.9), and the NRS of procedural pain of the protocol group was significantly decreased compared to the control group (4.8 ± 2.8 versus 3.7 ± 2.5). CAPS and HDRS were decreased in the protocol group, but did not have statistical significance. STAIS and HRSS were decreased in the protocol group, but only the STAIS had statistical significance.

Conclusion

Our new pain management system was effective in burn pain management. However, adequate pain management can only be accomplished by a continuous and thorough effort. Therefore, pain control protocol and pain monitoring systems need to be under constant revision and improvement using creative ideas and approaches.
Keywords:Pain management protocol  Routine pain monitoring  Burn pain
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