Nonpharmacological interventions ease burn pains
Nonpharmacological interventions appear to be effective in reducing burn pain and may serve as useful adjuncts to pharmacological standard care, a recent meta-analysis has found.
A comprehensive literature search in the databases of PsycINFO, Web of Science and Medline resulted in 21 randomized controlled trials (RCTs) eligible for analysis. The cumulative sample size was 660 patients (weighted mean age 35.1±6.1 years; 76 percent male), in whom the mean total body surface area was 17.2 percent.
Across all studies, nonpharmacological interventions resulted in a moderate but significant beneficial effect on pain outcomes (Hedges’ g, 0.58; 95 percent CI, 0.33–0.84; p<0.001), though heterogeneity was significant (p<0.001).
Subanalyses according to controls significantly altered the results. Nonpharmacological methods remained significantly effective when compared against treatment as usual (g, 0.69; 0.40–0.98; p<0.001), but not against attention controls (g, 0.21; –0.11 to 0.54; p=0.195).
In addition, nonpharmacological interventions also exerted a small but significant effect on patient anxiety (g, 0.36; 0.20–0.52; p<0.001), with little heterogeneity (p=0.816).
In terms of study quality, many of the studies did not report enough information to allow for the evaluation of risk of bias, particularly for selection and reporting bias. However, most studies did not ensure the blinding of medical personnel, suggesting that there may have been performance bias.
“According to the current status of evidence, particularly [virtual reality] distraction, hypnosis, and a combination of relaxation and distraction could be recommended for relieving pain and reducing anxiety during burn wound care in addition to standard pharmacological approaches,” said researchers, though stronger evidence is needed.