Reliance on opioids as the dominant or only analgesic is associated with harms including not only higher opioid requirements and significant side-effects e.g. nausea, constipation, drowsiness, but also dependence, diversion, and overdose. One should implement a multi-modal analgesic strategy including acetaminophen and NSAIDS if there are no contra-indications. One should also consider medications directed at neuropathic pain (e.g. gabapentin, pregabalin, duloxetine, amitriptyline), as well as physical (e.g. positioning) and psychological (e.g. distraction, relaxation, meditation) interventions to optimize mental health, reduce anxiety and promote effective sleep.
For more information:
James DL, Jowza M. Principles of Burn Pain Management. Clin Plast Surg. 2017; 44(4):737-747. PMID: 28888299.
Kim DE, Pruskowski KA, Ainsworth CR, Linsenbardt HR, Rizzo JA, Cancio LC. A Review of Adjunctive Therapies for Burn Injury Pain During the Opioid Crisis. J Burn Care Res. 2019; 40(6):983-995. PMID: 31259369.
Morgan M, Deuis JR, Frøsig-Jørgensen M, et al. Burn Pain: A Systematic and Critical Review of Epidemiology, Pathophysiology, and Treatment. Pain Med. 2018;19(4):708-734. PMID: 29036469.