Abstract
PURPOSE: The purpose of the study was to measure the prevalence of acute neuropathic pain in patients with acute burn injuries and the demographic and clinical characteristics of neuropathic pain in this population. We also evaluated the proportion of patients who received twice-daily evaluation of nurses' documentation of neuropathic pain following introduction of a validated neuropathic pain assessment tool embedded within the pain chart.
DESIGN: Retrospective, descriptive study.
SUBJECTS AND SETTING: The sample comprised 86 patients with second- and third-degree burn injuries. The research setting was a burn injury unit in a provincial center in British Columbia, Canada.
METHODS: Medical records over a 1-year prior following introduction of assessment of neuropathic pain into pain charts were retrospectively reviewed, and data collection focused on evidence of nurses undertaking acute neuropathic pain assessment as well as prevalence of report of acute neuropathic pain signs among this patient group. Neuropathic pain was evaluated twice daily using the Douleur Neuropathique 4, a previously validated neuropathic pain assessment tool.
RESULTS: Eighty percent of patients cared for received twice-daily neuropathic pain assessment. The prevalence of patients with neuropathic pain based on the Douleur Neuropathique instrument scores was 42%. Males reported neuropathic signs more than female patients, and patients with a greater than 10% body surface burn had a higher prevalence of neuropathic pain.
CONCLUSION: Study findings suggest that patients with acute burn injury are at risk of neuropathic pain. We recommend that nurse assessment of neuropathic pain becomes routine during the acute injury phase.