{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T20:41:22Z","timestamp":1780605682454,"version":"3.54.1"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2021,7,24]],"date-time":"2021-07-24T00:00:00Z","timestamp":1627084800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100006988","name":"John S Dunn Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006988","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Non-Medical Opioid Use Core Resource"},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["UL1TR003167"],"award-info":[{"award-number":["UL1TR003167"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,11,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>In 2019, we implemented a pill-based, opioid-minimizing pain protocol and protocolized moderate sedation for dressing changes in order to decrease opioid exposure in burn patients. We hypothesized that these interventions would reduce inpatient opioid exposure without increasing acute pain scores. Two groups of consecutive patients admitted to the burn service were compared: Pre-group (from January 1, 2018 to July 31, 2019) and Post-group (from January 1, 2020 to June 30, 2020) from before and after the implementation of the protocols (from August 1, 2019 to December 31, 2019). We abstracted patient demographics and burn injury characteristics from the burn registry. We obtained opioid exposure and pain scale scores from the electronic medical record. The primary outcome was total morphine milligram equivalents (MMEs). Secondary outcomes included MMEs\/day, pain domain-specific MMEs, and pain scores. Pain was estimated by creating a normalized pain score (range 0\u20131), which incorporated three different pain scales (Numeric Rating Scale, Behavioral Pain Scale, and Behavioral Pain Assessment Scale). Groups were compared using Wilcoxon rank-sum and chi-square tests. Treatment effects were estimated using Bayesian generalized linear models. There were no differences in demographics or burn characteristics between the Pre-group (n = 495) and Post-group (n = 174). The Post-group had significantly lower total MMEs (Post-group 110 MMEs [32, 325] vs Pre-group 230 [60, 840], P &amp;lt; .001), MMEs\/day (Post-group 33 MMEs\/day [15, 54] vs Pre-group 52 [27, 80], P &amp;lt; .001), and domain-specific total MMEs. No difference in average normalized pain scores was seen. Implementation of opioid-minimizing protocols for acute burn pain was associated with a significant reduction in inpatient opioid exposure without an increase in pain scores.<\/jats:p>","DOI":"10.1093\/jbcr\/irab143","type":"journal-article","created":{"date-parts":[[2021,7,24]],"date-time":"2021-07-24T13:09:47Z","timestamp":1627132187000},"page":"1146-1151","source":"Crossref","is-referenced-by-count":8,"title":["Impact of Opioid-Minimizing Pain Protocols After Burn Injury"],"prefix":"10.1093","volume":"42","author":[{"given":"Deepanjli","family":"Donthula","sequence":"first","affiliation":[{"name":"Department of Surgery, McGovern Medical School at the University of Texas Health Science Center at Houston, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher R","family":"Conner","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, McGovern Medical School at the University of Texas Health Science Center at Houston, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Van Thi Thanh","family":"Truong","sequence":"additional","affiliation":[{"name":"Center for Clinical Research and Evidence-Based Medicine, McGovern Medical School at the University of Texas Health Science Center at Houston, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Green","sequence":"additional","affiliation":[{"name":"Center for Clinical Research and Evidence-Based Medicine, McGovern Medical School at the University of Texas Health Science Center at Houston, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuantao","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Surgery, McGovern Medical School at the University of Texas Health Science Center at Houston, USA"},{"name":"John S. Dunn Burn Center at Memorial Hermann Hospital\u2013Texas Medical Center, Houston, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael W","family":"Wandling","sequence":"additional","affiliation":[{"name":"Department of Surgery, McGovern Medical School at the University of Texas Health Science Center at Houston, USA"},{"name":"John S. Dunn Burn Center at Memorial Hermann Hospital\u2013Texas Medical Center, Houston, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Spogmai","family":"Komak","sequence":"additional","affiliation":[{"name":"Department of Surgery, McGovern Medical School at the University of Texas Health Science Center at Houston, USA"},{"name":"John S. Dunn Burn Center at Memorial Hermann Hospital\u2013Texas Medical Center, Houston, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Todd F","family":"Huzar","sequence":"additional","affiliation":[{"name":"Department of Surgery, McGovern Medical School at the University of Texas Health Science Center at Houston, USA"},{"name":"John S. Dunn Burn Center at Memorial Hermann Hospital\u2013Texas Medical Center, Houston, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sasha D","family":"Adams","sequence":"additional","affiliation":[{"name":"Department of Surgery, McGovern Medical School at the University of Texas Health Science Center at Houston, USA"},{"name":"John S. Dunn Burn Center at Memorial Hermann Hospital\u2013Texas Medical Center, Houston, USA"},{"name":"Department of Surgery, McGovern Medical School at the University of Texas Health Science Center at Houston, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel J","family":"Freet","sequence":"additional","affiliation":[{"name":"Department of Surgery, McGovern Medical School at the University of Texas Health Science Center at Houston, USA"},{"name":"John S. Dunn Burn Center at Memorial Hermann Hospital\u2013Texas Medical Center, Houston, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J","family":"Wainwright","sequence":"additional","affiliation":[{"name":"Department of Surgery, McGovern Medical School at the University of Texas Health Science Center at Houston, USA"},{"name":"John S. Dunn Burn Center at Memorial Hermann Hospital\u2013Texas Medical Center, Houston, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles E","family":"Wade","sequence":"additional","affiliation":[{"name":"Department of Surgery, McGovern Medical School at the University of Texas Health Science Center at Houston, USA"},{"name":"John S. Dunn Burn Center at Memorial Hermann Hospital\u2013Texas Medical Center, Houston, USA"},{"name":"Department of Surgery, McGovern Medical School at the University of Texas Health Science Center at Houston, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lillian S","family":"Kao","sequence":"additional","affiliation":[{"name":"Department of Surgery, McGovern Medical School at the University of Texas Health Science Center at Houston, USA"},{"name":"Center for Clinical Research and Evidence-Based Medicine, McGovern Medical School at the University of Texas Health Science Center at Houston, USA"},{"name":"John S. Dunn Burn Center at Memorial Hermann Hospital\u2013Texas Medical Center, Houston, USA"},{"name":"Center for Translational Injury Research, McGovern Medical School at the University of Texas Health Science Center at Houston, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2081-6256","authenticated-orcid":false,"given":"John A","family":"Harvin","sequence":"additional","affiliation":[{"name":"Department of Surgery, McGovern Medical School at the University of Texas Health Science Center at Houston, USA"},{"name":"Center for Clinical Research and Evidence-Based Medicine, McGovern Medical School at the University of Texas Health Science Center at Houston, USA"},{"name":"John S. 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