• Danielle C Orrey, Omar I Halawa, Andrey V Bortsov, Jeffrey W Shupp, Samuel W Jones, Linwood R Haith, Janelle M Hoskins, Marion H Jordan, Shrikant I Bangdiwala, Brandon R Roane, Timothy F Platts-Mills, James H Holmes, James Hwang, Bruce A Cairns, and Samuel A McLean.
• *Department of Surgery, University of North Carolina, Chapel Hill §Wake Forest Baptist Medical Center, Winston-Salem, NC †Washington Hospital Center, Washington, DC ‡Crozer Chester Medical Center, Upland, PA.
• Clin J Pain. 2015 Jan 1; 31 (1): 21-9.

BackgroundResults of previous studies suggest that β-adrenoreceptor activation may augment pain, and that β-adrenoreceptor antagonists may be effective in reducing pain, particularly in individuals not homozygous for the catechol-O-methyltransferase (COMT) high-activity haplotype.Materials And MethodsConsenting patients admitted for thermal burn injury at participating burn centers were genotyped; those who were not high-activity COMT homozygotes were randomized to propranolol 240 mg/d or placebo. Primary outcomes were study feasibility (consent rate, protocol completion rate) and pain scores on study days 5 to 19. Secondary outcomes assessed pain and posttraumatic stress disorder symptoms 6 weeks postinjury.ResultsSeventy-seven percent (61/79) of eligible patients were consented and genotyped, and 77% (47/61) were genotype eligible and randomized. Ninety-one percent (43/47) tolerated study drug and completed primary outcome assessments. In intention-to-treat and per-protocol analyses, patients randomized to propranolol had worse pain scores on study days 5 to 19.ConclusionsGenotype-specific pain medication interventions are feasible in hospitalized burn patients. Propranolol is unlikely to be a useful analgesic during the first few weeks after burn injury.

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