Muhammad Adil Abbas Khan, Thomas Reekie, Breakey R, Mark Gorman, Mritunjay Kumar Varma, Simon Law.
Efficacy and patient acceptability of analgesia by intranasal diamorphine in burns patients: results of a pilot project.
Anesth Pain Intens Care Jan ;17(2):128-30.

Objective: To objectively assess intranasal diamorphine as an analgesic adjuvant for change of dressings in burn patients. Methodology: Eleven patients were recruited at a regional burns centre for this pilot study. Intranasal diamorphine at a weight-calculated dose was administered through an atomizer and patient vital signs and APVU scores were documented pre and post administration. A post-procedural satisfaction questionnaire was also completed by all patients. Results: Eleven patients (8 males and 3 females) were recruited for this pilot project. Mean age was 34 years (19-57 years) and mean burn total body surface area (TBSA) was 8.9% (4-17%). Procedure duration was a mean of 53.0 minutes (30-72 minutes). Six of the patients had a past history of opiate use. The data of our small-scale study shows that it has good analgesic efficacy, rapid-onset, safety and high degree of patient satisfaction without the need for intravenous access. There were no side-effects and all patients expressed satisfaction with the analgesia given. Conclusion: Intranasal diamorphine provides effective analgesia for moderate to severe procedural pain and can be a safe analgesic adjuvant for change of dressings in burn patients.

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