Results of a Pilot Multicenter Genotype-based Randomized Placebo-controlled Trial of Propranolol to Reduce Pain After Major Thermal Burn Injury
| Autor: | Samuel A. McLean, Marion H. Jordan, James H. Holmes, Janelle M. Hoskins, Omar I. Halawa, Shrikant I. Bangdiwala, Bruce A. Cairns, Brandon R. Roane, Linwood R. Haith, Andrey V. Bortsov, Samuel W. Jones, Timothy F. Platts-Mills, James Hwang, Jeffrey W. Shupp, D. Orrey |
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| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
Adult
Male Time Factors Genotype Adrenergic beta-Antagonists Burn Units Placebo-controlled study Pain Pilot Projects Propranolol Catechol O-Methyltransferase Polymorphism Single Nucleotide Article law.invention Young Adult chemistry.chemical_compound Double-Blind Method Randomized controlled trial law Humans Medicine Young adult Pain Measurement Catechol-O-methyl transferase business.industry Meth Thermal burn Treatment Outcome Anesthesiology and Pain Medicine chemistry Anesthesia Patient Compliance Female Neurology (clinical) Augment Burns business Follow-Up Studies medicine.drug |
| DOI: | 10.17615/v2g2-hd63 |
| Popis: | 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.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.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.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. |
| Databáze: | OpenAIRE |
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