Pain management during a bromelain-based selective enzymatic debridement in paediatric and adult burn patients

Abstract Burn patients experience anxiety and pain in the course of their injury, treatment, and recovery. Hence, treatment of anxiety and pain is paramount after burn injury. Children, in particular, pose challenges in anxiety and pain management due to their unique physiologic, psychologic, and anatomic status. Burn injuries further complicate pain management and sedation as such injuries can have effects on medication response and elimination. Burn injuries further complicate pain management and sedation as such injuries can have effects on medication response and elimination. The purpose of this review is to describe the challenges associated with management of anxiety, pain, and sedation in burned children and to describe the different options for treatment of anxiety and pain in burned children.

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Sedation and Pain Management in Burn Patients

Clinics in Plastic Surgery ◽

10.1016/j.cps.2017.02.026 ◽

2017 ◽

Vol 44 (3) ◽

pp. 535-540 ◽

Cited By ~ 20

Author(s):

Cornelia Griggs ◽

Jeremy Goverman ◽

Edward A. Bittner ◽

Benjamin Levi

Keyword(s):

Pain Management ◽

Burn Patients

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Acute pain management in burn patients: Appraisal and thematic analysis of four clinical guidelines

Burns ◽

10.1016/j.burns.2014.08.020 ◽

2014 ◽

Vol 40 (8) ◽

pp. 1463-1469 ◽

Cited By ~ 26

Author(s):

Hejdi Gamst-Jensen ◽

Pernille Nygaard Vedel ◽

Viktoria Oline Lindberg-Larsen ◽

Ingrid Egerod

Keyword(s):

Pain Management ◽

Thematic Analysis ◽

Acute Pain ◽

Clinical Guidelines ◽

Burn Patients ◽

Acute Pain Management

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Effect of Topical Local Anesthetic Application to Skin Harvest Sites for Pain Management in Burn Patients Undergoing Skin-Grafting Procedures

Annals of Surgery ◽

10.1097/00000658-199901000-00015 ◽

1999 ◽

Vol 229 (1) ◽

pp. 115-120 ◽

Cited By ~ 32

Author(s):

W. Scott Jellish ◽

Richard L. Gamelli ◽

Patricia A. Furry ◽

Victoria L. McGill ◽

Elaine M. Fluder

Keyword(s):

Pain Management ◽

Local Anesthetic ◽

Skin Grafting ◽

Burn Patients

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A Review of Adjunctive Therapies for Burn Injury Pain During the Opioid Crisis

Journal of Burn Care & Research ◽

10.1093/jbcr/irz111 ◽

2019 ◽

Vol 40 (6) ◽

pp. 983-995 ◽

Cited By ~ 7

Author(s):

Daniel E Kim ◽

Kaitlin A Pruskowski ◽

Craig R Ainsworth ◽

Hans R Linsenbardt ◽

Julie A Rizzo ◽

...

Keyword(s):

Pain Management ◽

Randomized Controlled Trials ◽

Systematic Reviews ◽

Burn Injury ◽

The United States ◽

Pain Severity ◽

Controlled Trials ◽

Burn Patients ◽

Opioid Use ◽

Randomized Controlled

Abstract Opioids are the mainstay of pain management after burn injury. The United States currently faces an epidemic of opioid overuse and abuse, while simultaneously experiencing a nationwide shortage of intravenous narcotics. Adjunctive pain management therapies must be sought and utilized to reduce the use of opioids in burn care to prevent the long-term negative effects of these medications and to minimize the dependence on opioids for analgesia. The purpose of this review was to identify literature on adjunctive pain management therapies that have been demonstrated to reduce pain severity or opioid consumption in adult burn patients. Three databases were searched for prospective studies, randomized controlled trials, and systematic reviews that evaluated adjunctive pain management strategies published between 2008 and 2019 in adult burn patients. Forty-six studies were analyzed, including 24 randomized controlled trials, six crossover trials, and 10 systematic reviews. Various adjunctive pain management therapies showed statistically significant reduction in pain severity. Only one randomized controlled trial on music therapy for acute background pain showed a reduction in opioid use. One cohort study on hypnosis demonstrated reduced opioid use compared with historical controls. We recommend the development of individualized analgesic regimens with the incorporation of adjunctive therapies in order to improve burn pain management in the midst of an abuse crisis and concomitant national opioid shortage.

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