Abstract

Pain Management by a Combination of Tramadol, Haloperidol and Carbamazepine in Iraqi Burn Patients

Author(s):Waleed Ibraheem Ali, Eman Abdul Yemmah Hadi, Zuhair A. Al-Johar

Objectives: To study the effectiveness of the drug combination of haloperidol, carbamazepine, and tramadol for pain management in burn patients during a daily change of dressing for the first seven days of hospitalization. Patients and methods: Study was done on 30 burn patients (aged: 12-45 years) who were admitted to the burn specialist hospital, Medical city complex in Baghdad, Iraq from February 2016 to June 2016. In this study, we depended on using carbamazepine (given orally in a dose of 100- 200 mg twice per day) with haloperidol (0.05-0.15 mg/kg orally once daily) and tramadol (300 mg to 400 mg continues infusion for 12 hours). During the study, the pain was monitored by using a pain scale for adults and children, and behavior of patients was monitored by using an observational pain assessment scale. Vital parameters like pulse rate, systolic and diastolic blood pressure, duration of sleep for each patient were recorded on the first day of treatment with these drugs up till the seventh day. Results: Systolic and diastolic BP dropped by (95%CI: 9-21 mmHg; 4-13 mmHg respectively) and heart rate dropped by (95%CI: 25 to 37 b/min); duration of sleep increased to 6-7 hours per day in 19 patients (95%CI: 0.45-0.81). The median total pain score of 30 burn patients dropped from 9 to 1 over seven days; and 18 of 30 patients (95% CI: 0.4-0.75) became more calm, cooperative, relaxed, normal tone, no crying, and no negative response to wound touching. Conclusions: Tramadol infusion, oral haloperidol, and oral carbamazepine combination are effective in managing pain in burn patients.

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