Pain management in major paediatric trauma and burns

Pain management in major paediatric trauma and burns is challenging. It involves many phases including pre-hospital and emergency department care, ward management frequently including intensive care, and multiple operative and procedural interventions (as inpatients and later outpatients). Distress, anxiety, post-traumatic stress disorder (from the primary event and the ensuing in-hospital and post-discharge course), itch, neuropathic pain (in addition to pain of nociceptive origin), and sleep disorders frequently affect major trauma and burns victims and can persist long term. An evidence-based discussion follows of the pharmacological and non-pharmacological interventions employed during these various phases to address pain and the associated issues in these patients.