Results of a pilot multicenter genotype-based randomized placebo-controlled trial of propranolol to reduce pain after major thermal burn injury.
- 2015
Available online from MWHC library: 1996 - present
BACKGROUND: Results of previous studies suggest that beta-adrenoreceptor activation may augment pain, and that beta-adrenoreceptor antagonists may be effective in reducing pain, particularly in individuals not homozygous for the catechol-O-methyltransferase (COMT) high-activity haplotype. 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. 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.
English
0749-8047
*Adrenergic beta-Antagonists/tu [Therapeutic Use] *Burns/co [Complications] *Catechol O-Methyltransferase/ge [Genetics] *Pain *Polymorphism, Single Nucleotide/ge [Genetics] *Propranolol/tu [Therapeutic Use] Adult Burn Units Burns/dt [Drug Therapy] Double-Blind Method Female Follow-Up Studies Genotype Humans Male Pain Measurement Pain/dt [Drug Therapy] Pain/et [Etiology] Pain/ge [Genetics] Patient Compliance/px [Psychology] Pilot Projects Time Factors Treatment Outcome Young Adult