Early opioid use in acute severe burn injuries and long-term pain and quality of life

Introduction: Pain management in the intensive care unit (ICU) following severe burn injury, particularly the use of high dose opioid therapy, may contribute to the development of long-term pain and impact long term health-related quality of life. This study aims to describe the analgesic management...

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Main Authors: Tessa Garside, Lachlan Donaldson, Emily Fitzgerald, Bao Teng, Anthony Delaney
Format: Article
Language:English
Published: Elsevier 2025-04-01
Series:Burns Open
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Online Access:http://www.sciencedirect.com/science/article/pii/S2468912225000094
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author Tessa Garside
Lachlan Donaldson
Emily Fitzgerald
Bao Teng
Anthony Delaney
author_facet Tessa Garside
Lachlan Donaldson
Emily Fitzgerald
Bao Teng
Anthony Delaney
author_sort Tessa Garside
collection DOAJ
description Introduction: Pain management in the intensive care unit (ICU) following severe burn injury, particularly the use of high dose opioid therapy, may contribute to the development of long-term pain and impact long term health-related quality of life. This study aims to describe the analgesic management and long-term self-rated health-related quality of life, including functional, psychological and pain outcomes, in patients admitted to ICU with a major burn injury. Methods: This was a retrospective analysis of prospectively collected data. All patients who were admitted to a tertiary referral intensive care unit with burns ≥20 % of total body surface area (TBSA) and survived to hospital discharge were included. Data relating to the severity of injury and analgesia management were collected for each patient. Patients completed follow up with the EQ-5D-5L questionnaire at 6- and 12-months post burn injury. Results: 84 patients were included. Seventy eight percent of patients reported long term issues with pain at 12 month follow up. Seventy-four percent of patients reported issues at 12 months with usual activities and 78 % reported issues with anxiety and depression. The mean dose of opioids (oral morphine equivalent dosing) prescribed to patients who reported issues with pain was not significantly different to those who did not report issues with pain at long term follow up (5079 (SD 7006) mg vs 3599 (SD 3175) mg, p = 0.2). Conclusions: Patients who suffer major burns requiring ICU admission have long term issues with pain/discomfort, mobility, usual activities, self-care, and anxiety and depression, that are greater than reported in the general burns population. The total dose of opioids given in the acute stage of injury do not seem to influence the prevalence of long-term pain/discomforts in burn patients.
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spelling doaj-art-8c7bc8cfc93f4f6b8d0b868466a78d9d2025-08-20T03:06:05ZengElsevierBurns Open2468-91222025-04-011010040110.1016/j.burnso.2025.100401Early opioid use in acute severe burn injuries and long-term pain and quality of lifeTessa Garside0Lachlan Donaldson1Emily Fitzgerald2Bao Teng3Anthony Delaney4Malcolm Fisher Department of Intensive Care Medicine, Royal North Shore Hospital, Australia; University of Sydney, Australia; Corresponding author at: Malcolm Fisher Department of Intensive Care Medicine, Royal North Shore Hospital, Australia.Malcolm Fisher Department of Intensive Care Medicine, Royal North Shore Hospital, Australia; University of Sydney, AustraliaMalcolm Fisher Department of Intensive Care Medicine, Royal North Shore Hospital, Australia; University of Sydney, AustraliaMalcolm Fisher Department of Intensive Care Medicine, Royal North Shore Hospital, AustraliaMalcolm Fisher Department of Intensive Care Medicine, Royal North Shore Hospital, Australia; University of Sydney, Australia; The George Institute, Newtown, NSW, AustraliaIntroduction: Pain management in the intensive care unit (ICU) following severe burn injury, particularly the use of high dose opioid therapy, may contribute to the development of long-term pain and impact long term health-related quality of life. This study aims to describe the analgesic management and long-term self-rated health-related quality of life, including functional, psychological and pain outcomes, in patients admitted to ICU with a major burn injury. Methods: This was a retrospective analysis of prospectively collected data. All patients who were admitted to a tertiary referral intensive care unit with burns ≥20 % of total body surface area (TBSA) and survived to hospital discharge were included. Data relating to the severity of injury and analgesia management were collected for each patient. Patients completed follow up with the EQ-5D-5L questionnaire at 6- and 12-months post burn injury. Results: 84 patients were included. Seventy eight percent of patients reported long term issues with pain at 12 month follow up. Seventy-four percent of patients reported issues at 12 months with usual activities and 78 % reported issues with anxiety and depression. The mean dose of opioids (oral morphine equivalent dosing) prescribed to patients who reported issues with pain was not significantly different to those who did not report issues with pain at long term follow up (5079 (SD 7006) mg vs 3599 (SD 3175) mg, p = 0.2). Conclusions: Patients who suffer major burns requiring ICU admission have long term issues with pain/discomfort, mobility, usual activities, self-care, and anxiety and depression, that are greater than reported in the general burns population. The total dose of opioids given in the acute stage of injury do not seem to influence the prevalence of long-term pain/discomforts in burn patients.http://www.sciencedirect.com/science/article/pii/S2468912225000094severe burn injurychronic painopioidanalgesiaintensive carelong term outcomes
spellingShingle Tessa Garside
Lachlan Donaldson
Emily Fitzgerald
Bao Teng
Anthony Delaney
Early opioid use in acute severe burn injuries and long-term pain and quality of life
Burns Open
severe burn injury
chronic pain
opioid
analgesia
intensive care
long term outcomes
title Early opioid use in acute severe burn injuries and long-term pain and quality of life
title_full Early opioid use in acute severe burn injuries and long-term pain and quality of life
title_fullStr Early opioid use in acute severe burn injuries and long-term pain and quality of life
title_full_unstemmed Early opioid use in acute severe burn injuries and long-term pain and quality of life
title_short Early opioid use in acute severe burn injuries and long-term pain and quality of life
title_sort early opioid use in acute severe burn injuries and long term pain and quality of life
topic severe burn injury
chronic pain
opioid
analgesia
intensive care
long term outcomes
url http://www.sciencedirect.com/science/article/pii/S2468912225000094
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AT emilyfitzgerald earlyopioiduseinacutesevereburninjuriesandlongtermpainandqualityoflife
AT baoteng earlyopioiduseinacutesevereburninjuriesandlongtermpainandqualityoflife
AT anthonydelaney earlyopioiduseinacutesevereburninjuriesandlongtermpainandqualityoflife