Management of pain and other discomforts in burned patients

Walter J. Meyer, J. A.Jeevendra Martyn, Shelley Wiechman, Christopher R. Thomas, Lee C Woodson

Research output: Chapter in Book/Report/Conference proceedingChapter

3 Scopus citations

Abstract

Although a multidisciplinary approach including nonpharmacological modes of management are essential, pharmacological treatment remains the cornerstone of pain control in patients with burn injuries. Drug and dose selection must be made in the context of systemic changes that evolve over time and alter pharmacokinetics and pharmacodynamics. Opioids are the mainstay of therapy but are associated with certain adverse effects such as opiate induced hyperalgesia. A newly appreciated problem. neuropathic pain, is characterized by burning and itching in the areas of newly regenerating skin and at amputation site. Effective pharmacological analgesia requires the concomitant treatment of anxiety, depression and PTSD with anxiolytics and antidepressants to control the pain syndrome following burn injury. Pain protocols facilitate the systematic pain management. New non pharmacologic approaches such as virtual reality now have demonstrated effectiveness. Burn pain comprises background, breakthrough, procedural and postoperative pain. Each type of pain requires different drugs, doses, or strategies.

Original languageEnglish (US)
Title of host publicationTotal Burn Care
Subtitle of host publicationFifth Edition
PublisherElsevier Inc.
Pages679-696
Number of pages18
ISBN (Electronic)9780323497428
ISBN (Print)9780323476614
DOIs
StatePublished - Nov 30 2017

Keywords

  • Burn pain classification
  • Itch
  • NMDA receptors
  • Opiate induced hyperalgesia
  • Opiates for burn pain
  • Sedation for procedural pain

ASJC Scopus subject areas

  • Medicine(all)

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    Meyer, W. J., Martyn, J. A. J., Wiechman, S., Thomas, C. R., & Woodson, L. C. (2017). Management of pain and other discomforts in burned patients. In Total Burn Care: Fifth Edition (pp. 679-696). Elsevier Inc.. https://doi.org/10.1016/B978-0-323-47661-4.00064-2