Morphine (10, 20 mg) in a postoperative dressing used with patients after surgical debridement of burn wounds: A prospective, double-blinded, randomized, controlled trial.
Objective This is the first clinical trial to evaluate the analgesic effect of 10 and 20 mg of morphine used in a postoperative dressing with patients after surgical debridement of burn wounds. Approach In this randomized controlled trial, 20 adult patients with third-degree flame burns who had undergone surgical debridement under general anesthesia were randomly assigned to either group A, whose members were treated with a burn dressing that contained 10 mg of morphine, or group B, whose members were treated with a burn dressing that contained 20 mg of morphine; the dressing was also soaked with octenidine and phenoxyethanol in the case of both groups. The plasma morphine concen-trations were measured 1, 2, 3, and 6 hours after surgery, while the level of pain intensity was deter-mined on the Numeric Pain Rating Scale (NRS), and the occurrence of side-effects was observed. Results The serum morphine concentration levels were very low but statistically different between the two groups at all time points. The NRS value was similar in both groups at all time points (p>0.05). De-spite this, in group B the NRS value was 0 in all patients in postoperative hours 1, 2, and 3. No ad-verse effects of morphine sulfate were observed in any patient. Innovation This project is the first clinical study to have demonstrated that morphine administered in dressings in concentrations of 0.02-0.08 mg/ml significantly reduces the occurrence of pain. Conclusion The use of morphine in dressings after surgical treatment of burn wounds is very effective when it comes to pain management, and is safe for the patient.
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