Results of a Pilot Multicenter Genotype-based Randomized Placebo-controlled Trial of Propranolol to Reduce Pain After Major Thermal Burn Injury Academic Article uri icon

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abstract

  • 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.

authors

  • Orrey, Danielle C
  • Halawa, Omar I
  • Bortsov, Andrey V
  • Shupp, Jeffrey W
  • Jones, Samuel W
  • Haith, Linwood R
  • Hoskins, Janelle M
  • Jordan, Marion H
  • Bangdiwala, Shrikant
  • Roane, Brandon R
  • Platts-Mills, Timothy F
  • Holmes, James H
  • Hwang, James
  • Cairns, Bruce A
  • McLean, Samuel A

publication date

  • January 2015

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