Management of acute pain in extensive burn injury: Nonsystematic review of the literature
Keywords:
Pain; Acute Pain; Analgesics; Burns; Pain Management
Abstract
Introduction:
Management of acute pain is essential in the treatment of burned patients. Current pain management approaches focus on the control of the somatic component reflecting the insult. However, the injury comprises emotional, physical, and psychological components that require multi-disciplinary management, including pharmacological and nonpharmacological interventions to break the vicious circle of pain and its complications.
Objective:
To perform a nonsystematic review of the literature on the pharmacological and nonpharmacological management of pain in patients with extensive burns.
Methods:
Nonsystematic review of the literature published between 2000 and 2016 in MEDLINE/PubMed, Embase, Sciencedirect, SciELO, LILACS, Google Scholar, academic books, and institutional management guidelines.
Results:
After analyzing the literature, it was found that the management of acute pain in the patients with severe burn injury should be based on a multidisciplinary approach.
Conclusions:
Management of acute pain in patients with severe burn injury should not focus only on the somatic components of pain but should also encompass the emotional, physical, and psychosocial components, in order to provide comprehensive management, both pharmacological and nonpharmacological.
References
1. Browne A, Andrews R, Schug S, et al. Persistent pain outcomes and patient satisfaction with pain management after burn injuries. Clin J Pain 2011; 27:136-145.
2. Ramírez C, Ramírez C, González L, et al. Fisiopatología del paciente quemado. Reu Salud UIS 2010; 42:55-65.
3. Dauber A, Osgood P, Breslau A, et al. Chronic persistent pain after severe burns: a survey of 358 burn survivors. Pain Med 2002; 3:6-17.
4. Dyster-Aas J, Willebrand M, Wikehult B, et al. Major depression and posttraumatic stress disorder symptoms following severe burn injury in relation to lifetime psychiatric morbidity. J Trauma 2008; 64:1349-1356.
5. Patterson D, TininenkoJ, PtacekJ. Pain during burn hospitalization predicts long term outcome. J Burn Care Res 2006; 27:719-726.
6. Faucher L, Furukawa K. Practice guidelines for the management of pain. J Burn Care Res 2006; 27:659-668.
7. European Burns Association. Practice Guidelines for Burn Care, 2nd ed. Vienna; 2013.
8. Larrea B, Avila M, Raddatz C. Manejo de dolor en pacientes quemados. Reu Chil Anest 2015; 44:78-95.
9. Midlands Burn Care Network, Guidelines For Pain and Itch Management For Patients Within The Midland Burn Care Network, Birmingham (England). 1 Ed. 2011.
10. Alencar R, Cunha P, Kimiko R. Tratamiento del dolor en quemados. Reu Bras Anestesiol 2013; 63:149-158.
11. Aguilera F. Anestesia y manejo perioperatorio del paciente quemado. Reu Salud Bosque 2016; 6:65-78.
12. Macintyre P, Schug S, Scott D, et al; APM: SE Working Group of the Australian and New Zealand College of Anaesthetists and Faculty of Pain Medicine. Acute Pain Management: Scientific Evidence 3er ed. Melbourne: ANZCA & FPM; 2010.
13. Guidelines for Pain Management For patients within the Midland Burn Operational Delivery Network. Birmingham: Review date 2016.
14. Cordero I, Rodriguez R, Miquet L, et al. Conducta perioperatoria del paciente quemado. Reu Cub Anest Rean 2005; 4:75-92.
15. Ministerio de Salud de Chile Guía Clínica gran Quemado. Santiago: Minsal. 2007.
16. Marret E, Kurdi O, Zufferey P, et al. Effects of nonsteroidal, anti-inflammatory drugs on patient-controlled analgesia morphine side effects: meta-analysis of randomized, controlled trials. Anesthesiology 2005; 102:1249-1260.
17. Ramírez C, Ramírez C, Ramírez M, Ramírez N. Manejo del paciente quemado. Rev Univ Ind Santander Salud 2007:73-86.
18. Richardson P, Mustard L. The management of pain in the burns unit. Burns 2009; 35:921-936.
19. Ministerio de Salud de Chile Guías clínicas AUGE gran quemado. Santiago: Minsal 2016.
20. Zor F, Ozturk S, Bilgin F, et al. Pain relief during dressing changes of major adult burns: ideal analgesic combination with ketamine. Burns 2010; 36:501-505.
21. Larrea B. Dolor en trauma térmico. Boletín el dolor 2006; 15:14-25.
22. Morgan Ge. Morgan GE. Coadyuvantes de la Anestesia. Anestesiología Clínica 4 ed.2009; Mc Graw Hill, 277-279.
23. Walker J, MacCallum M, Fischer C, et al. Sedation using dexmedetomidine in pediatric burn patients. J Burn Care Res 2006; 27:206-210.
24. Kipping B, Rodger S, Miller K, et al. Virtual reality for acute pain reduction in adolescents undergoing burn wound care: a prospective randomized controlled trial. Burns 2012; 38:650657.
25. Mott J, Bucolo S, Cuttle L, et al. The efficacy of an augmented virual reality system to alleviate pain in children undergoing burns dressing changes: a randomised controlled trial. Burns 2008; 34:803-808.
26. Hoffman H, Chambers G, Meyer W, et al. Virtual reality as an adjunctive non-pharmacologic analgesic for acute burn pain during medical procedures. Ann Behau Med 2011; 41:183-191.
27. Jonhson S, Coxon M. Sound can enhance the analgesic effect of virtual reality. R Soc Open Sci 2016; 3:150567.
28. Hoffman H, Sharar S, Coda B, et al. Manipulating presence influences the magnitude of virtual reality analgesia. Pain 2004; 111:162-168.
29. Morris L, Louw Q Grimmer-Somers K. The effectiveness of virtual reality on reducing pain and anxiety in burn injury patients: a systematic review. Clin J Pain 2009; 25:815-826.
30. Vásquez K, García R, Cruz M, et al. Electroterapia como manejo alternativo del dolor en quemaduras. Reu San Milit Mex 2008; 62:141-144.
31. Gandhi M, Thomson C, Lord D, et al. Management of pain in children with burns. Int J Pediatr 2010; 2010:1-9.
32. Grey P, Kirby J, Smith M, et al. Pregabalin in severe burn injury pain: a double-blind, randomized placebo-controlled trial. Pain 2011; 52:1279-1288.
33. Grey P. Acute neuropathic pain, diagnosis and treatment. Curr Opin Anaesthesiol 2008; 21:590-595.
34. Wong L, Turner L. Treatment of postburn neuropathic pain: evaluation of pregrabalin. Burns 2010; 36:769-772.
35. Cuignet O, Pirson J, Soudon O, et al. Effects of gabapentin on morphine consumption and pain in severely burned patients. Burns 2007; 33:81-86.
36. Grey P, Williams B, Cramond T. Successful use of gabapentin in acute pain management following burn injury: a case series. Pain Med 2008; 9:371-376.
37. Ahuja R, Chatterjee P. Postburn pruritus: a practical review. Indian J Burns 2014; 22:13-22.
38. Ahuja R, Gupta G. A four arm, double blind, randomized and placebo controlled study of pregabalin in the management of postburn pruritus. Burns 2013; 39:24-29.
39. Goutos I, Eldardiri M, Khan A, et al. Comparative evaluation of antipruritic protocols in acute burns. The emerging value of gabapentin in the treatment of burn pruritus. J Burn Care Res 2010; 31:57-63.
40. Goutos I. Review of therapeutic agents for burns pruritus and protocols for management in adult and pediatric patients using the grade classification. Indian J Plast Surg 2010; 43:51-62.
41. Orellana M, Yañez , Gutiérrez J, et al. Prurito neuropático. Reuista el dolor 2012; 57:28-32.
42. Goutos I. Neuropathic mechanisms in the pathophysiology of burns pruritus: redefining directions for therapy and research. J Burn Care Res 2013; 34:82-93.
43. Connolly S. Clinical Practice Guidelines: Burn Patient Management. Sydney: Agency for Clinical Innovation, 2011.
44. Moix J. La hipnosis en el tratamiento del dolor. Reu Soc Esp Dolor 2002; 9:525-532.
45. Boyer E. Management of opiod analgesic overdose. N Engl J Med 2012; 367:146-155.
46. Mugabure B, González S, Uría A, et al. Actualizaciones en el manejo clínico de los opioides espinales en el dolor agudo postoperatorio. Reu Soc Esp Dolor 2012; 19:72-94.
47. Cadavid A. Analgesia opioide en el postoperatorio, en: Opiodes en la práctica médica. 2009; Asociación colombiana para el estudio del dolor, Bogotá (Colombia):45-66.
48. Acuña J. Intoxicación grave por psicofármacos. Reu Med Clin Condes 2011; 22:332-339.
49. Oses I, Burillo-Putze G, Munne P, et al. Intoxcaciones medicamentosas, psicofármacos y antiarrítmicos. ANALES Sis San Nauarra 2003; 26:49-63.
50. Eslava S. Aguilera F. Anestésicos endovenosos. Anestesiología y Medicina Perioperatoria 4th ed. Celsus: Bogotá; 2010; 158-164.
51. Zapantis A, Leung S. Tolerance and withdrawal issues with sedation. Crit Care Nurs Clin North Am 2005; 17:211-223.
52. Rivera R. Sedación y analgesia: una revisión. Acta Pediátr Costarricense 2002; 16:6-21.
53. Galinkin J, Lee J. Recognition and management of iatrogenically-induced opioid dependence and withdrawal in children. Pediatrics 2014; 133:152-155.
54. Suttner J, White A, Vernachio K. Best practices in tapering methods in patients undergoing opioid therapy. Adu Pharmacol Pharm 2013; 1:42-57.
55. Celis E, Besso J, Birchenall C, et al. Guía de práctica clínica basada en la evidencia para el manejo de la sedoanalgesia en el paciente adulto críticamente enfermo. Med Intensiva 2007; 31:428-471.
56. Baltieri D, Strain E, Dias J, et al. Brazilian guideline for the treatment of patients with opioids dependence syndrome. Reu Bras Psiquiatr 2004; 26:259-268.
2. Ramírez C, Ramírez C, González L, et al. Fisiopatología del paciente quemado. Reu Salud UIS 2010; 42:55-65.
3. Dauber A, Osgood P, Breslau A, et al. Chronic persistent pain after severe burns: a survey of 358 burn survivors. Pain Med 2002; 3:6-17.
4. Dyster-Aas J, Willebrand M, Wikehult B, et al. Major depression and posttraumatic stress disorder symptoms following severe burn injury in relation to lifetime psychiatric morbidity. J Trauma 2008; 64:1349-1356.
5. Patterson D, TininenkoJ, PtacekJ. Pain during burn hospitalization predicts long term outcome. J Burn Care Res 2006; 27:719-726.
6. Faucher L, Furukawa K. Practice guidelines for the management of pain. J Burn Care Res 2006; 27:659-668.
7. European Burns Association. Practice Guidelines for Burn Care, 2nd ed. Vienna; 2013.
8. Larrea B, Avila M, Raddatz C. Manejo de dolor en pacientes quemados. Reu Chil Anest 2015; 44:78-95.
9. Midlands Burn Care Network, Guidelines For Pain and Itch Management For Patients Within The Midland Burn Care Network, Birmingham (England). 1 Ed. 2011.
10. Alencar R, Cunha P, Kimiko R. Tratamiento del dolor en quemados. Reu Bras Anestesiol 2013; 63:149-158.
11. Aguilera F. Anestesia y manejo perioperatorio del paciente quemado. Reu Salud Bosque 2016; 6:65-78.
12. Macintyre P, Schug S, Scott D, et al; APM: SE Working Group of the Australian and New Zealand College of Anaesthetists and Faculty of Pain Medicine. Acute Pain Management: Scientific Evidence 3er ed. Melbourne: ANZCA & FPM; 2010.
13. Guidelines for Pain Management For patients within the Midland Burn Operational Delivery Network. Birmingham: Review date 2016.
14. Cordero I, Rodriguez R, Miquet L, et al. Conducta perioperatoria del paciente quemado. Reu Cub Anest Rean 2005; 4:75-92.
15. Ministerio de Salud de Chile Guía Clínica gran Quemado. Santiago: Minsal. 2007.
16. Marret E, Kurdi O, Zufferey P, et al. Effects of nonsteroidal, anti-inflammatory drugs on patient-controlled analgesia morphine side effects: meta-analysis of randomized, controlled trials. Anesthesiology 2005; 102:1249-1260.
17. Ramírez C, Ramírez C, Ramírez M, Ramírez N. Manejo del paciente quemado. Rev Univ Ind Santander Salud 2007:73-86.
18. Richardson P, Mustard L. The management of pain in the burns unit. Burns 2009; 35:921-936.
19. Ministerio de Salud de Chile Guías clínicas AUGE gran quemado. Santiago: Minsal 2016.
20. Zor F, Ozturk S, Bilgin F, et al. Pain relief during dressing changes of major adult burns: ideal analgesic combination with ketamine. Burns 2010; 36:501-505.
21. Larrea B. Dolor en trauma térmico. Boletín el dolor 2006; 15:14-25.
22. Morgan Ge. Morgan GE. Coadyuvantes de la Anestesia. Anestesiología Clínica 4 ed.2009; Mc Graw Hill, 277-279.
23. Walker J, MacCallum M, Fischer C, et al. Sedation using dexmedetomidine in pediatric burn patients. J Burn Care Res 2006; 27:206-210.
24. Kipping B, Rodger S, Miller K, et al. Virtual reality for acute pain reduction in adolescents undergoing burn wound care: a prospective randomized controlled trial. Burns 2012; 38:650657.
25. Mott J, Bucolo S, Cuttle L, et al. The efficacy of an augmented virual reality system to alleviate pain in children undergoing burns dressing changes: a randomised controlled trial. Burns 2008; 34:803-808.
26. Hoffman H, Chambers G, Meyer W, et al. Virtual reality as an adjunctive non-pharmacologic analgesic for acute burn pain during medical procedures. Ann Behau Med 2011; 41:183-191.
27. Jonhson S, Coxon M. Sound can enhance the analgesic effect of virtual reality. R Soc Open Sci 2016; 3:150567.
28. Hoffman H, Sharar S, Coda B, et al. Manipulating presence influences the magnitude of virtual reality analgesia. Pain 2004; 111:162-168.
29. Morris L, Louw Q Grimmer-Somers K. The effectiveness of virtual reality on reducing pain and anxiety in burn injury patients: a systematic review. Clin J Pain 2009; 25:815-826.
30. Vásquez K, García R, Cruz M, et al. Electroterapia como manejo alternativo del dolor en quemaduras. Reu San Milit Mex 2008; 62:141-144.
31. Gandhi M, Thomson C, Lord D, et al. Management of pain in children with burns. Int J Pediatr 2010; 2010:1-9.
32. Grey P, Kirby J, Smith M, et al. Pregabalin in severe burn injury pain: a double-blind, randomized placebo-controlled trial. Pain 2011; 52:1279-1288.
33. Grey P. Acute neuropathic pain, diagnosis and treatment. Curr Opin Anaesthesiol 2008; 21:590-595.
34. Wong L, Turner L. Treatment of postburn neuropathic pain: evaluation of pregrabalin. Burns 2010; 36:769-772.
35. Cuignet O, Pirson J, Soudon O, et al. Effects of gabapentin on morphine consumption and pain in severely burned patients. Burns 2007; 33:81-86.
36. Grey P, Williams B, Cramond T. Successful use of gabapentin in acute pain management following burn injury: a case series. Pain Med 2008; 9:371-376.
37. Ahuja R, Chatterjee P. Postburn pruritus: a practical review. Indian J Burns 2014; 22:13-22.
38. Ahuja R, Gupta G. A four arm, double blind, randomized and placebo controlled study of pregabalin in the management of postburn pruritus. Burns 2013; 39:24-29.
39. Goutos I, Eldardiri M, Khan A, et al. Comparative evaluation of antipruritic protocols in acute burns. The emerging value of gabapentin in the treatment of burn pruritus. J Burn Care Res 2010; 31:57-63.
40. Goutos I. Review of therapeutic agents for burns pruritus and protocols for management in adult and pediatric patients using the grade classification. Indian J Plast Surg 2010; 43:51-62.
41. Orellana M, Yañez , Gutiérrez J, et al. Prurito neuropático. Reuista el dolor 2012; 57:28-32.
42. Goutos I. Neuropathic mechanisms in the pathophysiology of burns pruritus: redefining directions for therapy and research. J Burn Care Res 2013; 34:82-93.
43. Connolly S. Clinical Practice Guidelines: Burn Patient Management. Sydney: Agency for Clinical Innovation, 2011.
44. Moix J. La hipnosis en el tratamiento del dolor. Reu Soc Esp Dolor 2002; 9:525-532.
45. Boyer E. Management of opiod analgesic overdose. N Engl J Med 2012; 367:146-155.
46. Mugabure B, González S, Uría A, et al. Actualizaciones en el manejo clínico de los opioides espinales en el dolor agudo postoperatorio. Reu Soc Esp Dolor 2012; 19:72-94.
47. Cadavid A. Analgesia opioide en el postoperatorio, en: Opiodes en la práctica médica. 2009; Asociación colombiana para el estudio del dolor, Bogotá (Colombia):45-66.
48. Acuña J. Intoxicación grave por psicofármacos. Reu Med Clin Condes 2011; 22:332-339.
49. Oses I, Burillo-Putze G, Munne P, et al. Intoxcaciones medicamentosas, psicofármacos y antiarrítmicos. ANALES Sis San Nauarra 2003; 26:49-63.
50. Eslava S. Aguilera F. Anestésicos endovenosos. Anestesiología y Medicina Perioperatoria 4th ed. Celsus: Bogotá; 2010; 158-164.
51. Zapantis A, Leung S. Tolerance and withdrawal issues with sedation. Crit Care Nurs Clin North Am 2005; 17:211-223.
52. Rivera R. Sedación y analgesia: una revisión. Acta Pediátr Costarricense 2002; 16:6-21.
53. Galinkin J, Lee J. Recognition and management of iatrogenically-induced opioid dependence and withdrawal in children. Pediatrics 2014; 133:152-155.
54. Suttner J, White A, Vernachio K. Best practices in tapering methods in patients undergoing opioid therapy. Adu Pharmacol Pharm 2013; 1:42-57.
55. Celis E, Besso J, Birchenall C, et al. Guía de práctica clínica basada en la evidencia para el manejo de la sedoanalgesia en el paciente adulto críticamente enfermo. Med Intensiva 2007; 31:428-471.
56. Baltieri D, Strain E, Dias J, et al. Brazilian guideline for the treatment of patients with opioids dependence syndrome. Reu Bras Psiquiatr 2004; 26:259-268.
How to Cite
1.
Cáceres-Jerez LE, Gomezese-Ribero OF, Reyes-Cárdenas LI, Vera Campos JA, Guzmán-Rueda VA, Azar-Villalobos JP, et al. Management of acute pain in extensive burn injury: Nonsystematic review of the literature. Colomb. J. Anesthesiol. [Internet]. 2018 Jan. 1 [cited 2024 Apr. 24];46(1):49-54. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/345
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Published
2018-01-01
How to Cite
1.
Cáceres-Jerez LE, Gomezese-Ribero OF, Reyes-Cárdenas LI, Vera Campos JA, Guzmán-Rueda VA, Azar-Villalobos JP, et al. Management of acute pain in extensive burn injury: Nonsystematic review of the literature. Colomb. J. Anesthesiol. [Internet]. 2018 Jan. 1 [cited 2024 Apr. 24];46(1):49-54. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/345
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Section
Narrative review
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