Pain and the thermally injured patient-a review of current therapies.
Thermally injured patients experience tremendous pain from the moment of injury to months or years after their discharge from the hospital. Pain is therefore a critical component of proper management of burns. Although the importance of pain is well recognized, it is often undertreated. Acute uncontrolled pain has been shown to increase the incidence of mental health disorders and increase the incidence of suicide after discharge. Long-term poor pain control leads to an increase in the incidence of persistent pain. Most burn centers have used opioids as the mainstay analgesic, but recently, the significant side effects of opioids have led to the implementation of new and combined therapeutics. Pharmacological agents such as gabapentin, clonidine, dexmedetomidine, and ketamine have all been suggested as adjuncts to opioids in the treatment of burn pain. Nonpharmacological therapies such as hypnosis, virtual reality devices, and behavioral therapy are also essential adjuncts to current medications. This review aims at identifying the currently available pharmacological and nonpharmacological options for optimal pain management in the adult burn population.
From the *Faculty of Medicine, McGill University, Montreal, Quebec, Canada; and †Department of Surgery, Division of Plastic and Reconstructive Surgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Helene
H
Retrouvey
Shahriar
S
Shahrokhi
D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001521:Behavior Therapy / Q000379:methods; D002053:Burn Units; D002056:Burns / Q000150:complications* / Q000188:drug therapy / Q000628:therapy*; D016638:Critical Illness / Q000628:therapy; D003428:Cross Infection / Q000517:prevention & control; D005260:Female; D006801:Humans; D017053:Infection Control / Q000379:methods; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000517:prevention & control*; D059408:Pain Management; D010147:Pain Measurement / Q000379:methods*
D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal