• Ross D MacPherson, David Woods, and Joanna Penfold.
• Department of Anaesthesia and Pain Management, Royal North Shore Hospital, Pacific Highway, St Leonards NSW, Australia. rmacpher@nsccahs.health.nsw.gov.au
• Clin J Pain. 2008 Sep 1;24(7):568-71.

BackgroundA study involving the use of a mixture of ketamine and midazolam delivered via patient-controlled analgesia (PCA) device was trialed to assess its effectiveness in reducing pain associated with repeated burns dressings in an adult population.MethodsPatients undergoing burns dressings changes were given a PCA device of ketamine and midazolam to use during the procedure. The aims were to investigate the efficacy of the device and to ascertain what (if any) adverse effects were associated with its use.ResultsDuring the trial period, 44 patients who underwent 95 separate procedures were enrolled. The effectiveness of the device was rated (out of 10) by both staff and patients with the mean scores being 8.47 and 8.50, respectively. In all but 1 case, the proposed procedure was carried out successfully. Thirteen patients reported a total of 23 adverse effects, with hallucinations (11) being the most common.ConclusionsThe use of ketamine/midazolam delivered by PCA was shown to be an effective means of pain control during burns dressings as assessed by both staff and patients. The incidence of adverse events was low.

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