Safety and efficacy of debridement under anesthesia in patients with burns.
Burn wound debridements requiring blunt or sharp manipulations are extremely painful even when large nonanesthetic doses of morphine are used. In this study we describe the use of debridement while the patient is under anesthesia (DUA) when manipulation of the wound is required. Seventy-one debridements were performed on 46 patients. One patient required additional fluids during the DUA, but no deaths, extensive blood losses, or significant changes in nutrition attributable to the DUA occurred. The mean number of required DUAs was 1.6 per patient compared with 6.0 per patient reported in a previous study from the same burn center that involved standard parenteral analgesic doses of morphine sulfate. Patients were completely anesthetized during the procedure. Therefore, they were free of pain and were amnestic for the experience. We conclude that DUA is a safe, efficacious procedure that permits full relief from the pain usually experienced during a manipulative burn wound debridement.
Department of Psychiatry and Behavioral Medicine, University of South Florida College of Medicine, Tampa.
P S
PS
Powers
C W
CW
Cruse
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S
Daniels
B A
BA
Stevens
D000328:Adult; D000768:Anesthesia, General; D002056:Burns / Q000453:epidemiology / Q000503:physiopathology / Q000601:surgery*; D003646:Debridement / Q000379:methods*; D004737:Enflurane; D005260:Female; D006801:Humans; D008297:Male; D009020:Morphine / Q000627:therapeutic use; D009609:Nitrous Oxide; D010146:Pain / Q000517:prevention & control*; D011292:Premedication; D012189:Retrospective Studies; D013874:Thiopental; D013997:Time Factors
D009020:Morphine; D004737:Enflurane; D013874:Thiopental; D009609:Nitrous Oxide