medigraphic.com

2021, Number 1

<< Back Next >>

Rev Mex Anest 2021; 44 (1)

Pain management in patients with severe burns

Cruz-Nocelo EJ, Zúñiga-Carmona VH, Serratos-Vázquez MC

Language: Spanish
References: 52
Page: 55-62
PDF size: 321.06 Kb.


ABSTRACT

Severe burns are characterized by inducing the most severe and sustained metabolic response than any other form of trauma. The treatment of pain in these patients is complex. In this review, the scientific support available in the current literature was integrated from a practical clinical approach in regard to the treatment of pain in the patient with burns; in turn, two representative schemes of the classification of pain and multimodal analgesia for the patient with major burns were integrated. Multimodal analgesia is the technique currently recommended for the treatment of burn pain; however, more research is required mainly with regard to analgesic adjuvants in burned patients. It is likely that the state of intense and persistent inflammation that characterizes these patients, which implies the massive genomic reorganization of the leukocyte transcriptome, contributes to the exceptional quality of the pain of the patient with burn injuries. The foundation of successful analgesic management could be in the search for specific regulatory anti-inflammatories for these patients. It is necessary to undertake the development of effective anti-inflammatories-analgesics with properties that allow them to overcome the challenge of the high variability of the pharmacological parameters of the patient with major burns.


REFERENCES

  1. Pereira CT, Murphy KD, Herndon DN. Altering metabolism. J Burn Care Rehabil. 2005;26:194-199.

  2. Kaiser HE, Meerim CK, Sharar SR, Olivar HP. Advances in perioperative and critical care of the burn patient. Adv Anesth. 2013;31:137-161.

  3. Perry S, Heidrich G, Ramos E. Assessment of pain in burned patients. J Burn Care Rehabil. 1981;2:322-326.

  4. Esfahlan AJ, Lotfi M, Zamanzadeh V, Babapuor J. Burn pain and patients' responses. Burns. 2010;36:1129-1133.

  5. Norman AT, Judkins KC. Pain in the patient with burns. Contin Educ Anaesth Crit Care Pain. 2004;4:57-61.

  6. Serratos-Vázquez MC. Manejo de dolor en el paciente con trauma. Rev Mex Anest. 2012;35 Supl 1:123-129.

  7. Williams FN, Jeschke MG, Chinkes DL, Suman OE, Branski LK, Herndon DN. Modulation of the hypermetabolic response to trauma: temperature, nutrition, and drugs. J Am Coll Surg. 2009;208:489-502.

  8. Gamst-Jensen H, Nygaard-Vedel P, Lindberg-Larsen VO, Egerod I. Acute pain management in burn patients: Appraisal and thematic analysis of four clinical guidelines. Burns. 2014;40:1463-1469.

  9. Greenhalgh DG. Sepsis in the burn patient: a different problem than sepsis in the general population. Burns Trauma. 2017;5:23.

  10. Xiao W, Mindrinos MN, Seok J, Cuschieri J, Cuenca AG, Gao H, et al. A genomic storm in critically injured humans. J Exp Med. 2011;208:2581-2590.

  11. De Lille FR. Fisiopatología del dolor. En: Guevara LUM, editor. Dolor por especialidades. México: Corinter; 2008. pp. 19-39.

  12. Beushausen T, Mucke K. Anesthesia and pain management in pediatric burn patients. Pediatr Surg Int. 1997;12:327-333.

  13. Wolf SE, Debroy M, Herndon DN. The cornerstones and direction of pediatric burn care. Pediatr Surg Int. 1997;12:312-320.

  14. Silvestre-Pérez MA, Matoses-Jaén MS, Peiró-Tudela MC, López-Navarro AM, Tomás-Braulio J. Anestesia y reanimación para el gran quemado pediátrico. Rev Esp Anestesiol Reanim. 2004;51:253-267.

  15. Demling RH. The burn edema process: current concepts. J Burn Care Rehabil. 2005;26:207-227.

  16. Ahrns KS. Trends of burn resuscitation: Shifting the focus from fluids to adecuate end point monitoring, edema control, and adyuvant therapies. Crit Care Nurs Clin North Am. 2004;16:75-98.

  17. Latenser BA. Critical care of the burn patient: the first 48 hours. J Crit Care Med. 2009;37:2819-2826.

  18. Fuchs PCh, Groger A, Bozkurt A, Johnen D, Wolter T, Pallua N. Cortisol in severely burned patients: investigations on disturbance of the hypothalamic-pituitary-adrenal axis. Shock. 2007;28:662-667.

  19. Summer GJ, Puntillo KA, Miaskowski C, Green PG, Levine JD. Burn injury pain: the continuing challenge. J Pain. 2007;8:533-548.

  20. Anderson TA, Fuzaylov G. Perioperative anesthesia management of the burn patient. Surg Clin North Am. 2014;94:851-861.

  21. Jeschke MG. The hepatic response to thermal injury: Is the liver important for postburn outcomes? Mol Med. 2009;15:337-351.

  22. Richardson P, Mustard L. The management of pain in the burns unit. Burns. 2009;35:921-936.

  23. Chou R, Gordon DB, De Leon-Casasola OA, Rosenberg JM, Bickler S, Brennan T, et al. Management of postoperative pain: A clinical practice guideline from the American Pain Society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists' Committee on Regional Anesthesia, executive committee, and administrative council. J Pain. 2016;17:131-157.

  24. McIntyre MK, Clifford JL, Maani CV, Burmeister DM. Progress of clinical practice on the management of burn-associated pain: Lessons from animal models. Burns. 2016;42:1161-1172.

  25. Falder S, Browne A, Edgar D, Staples E, Fong J, Rea S, et al. Core outcomes for adult burn survivors: A clinical overview. Burns. 2009;35:618-641.

  26. Jeschke MG, Gauglitz GG, Kulp GA, Finnerty CC, Williams FN, Kraft R, et al. Long-term persistence of the pathophysiologic response to severe burn injury. PLoS One. 2011;6:e21245.

  27. Blanchet B, Jullien V, Vinsonneau C, Tod M. Influence of burns on pharmacokinetics and pharmacodynamics of drugs used in the care of burn patients. Clin Pharmacokinet. 2008;47: 635-654.

  28. Yang HT, Hur G, Kwak IS, Yim H, Cho YS, Kim D, et al. Improvement of burn pain management through routine pain monitoring and pain management protocol. Burns. 2013;39:619-624.

  29. Retrouvey H, Shahrokhi S. Pain and the thermally injured patient- a review of current therapies. J Burn Care Res. 2015;36:315-323.

  30. Álvarez ET. Semiología del dolor. Iatreia. 2002;15:200-206.

  31. Zachariah JR, Rao AL, Prabha R, Gupta AK, Paul MK, Lamba S. Post burn pruritus-A review of current treatment options. Burns. 2012;38:621-629.

  32. Holtman JR Jr, Jellish WS. Opioid-induced hyperalgesia and burn pain. J Burn Care Res. 2012;33:692-701.

  33. Covarrubias-Gómez A, González García JL, Betancourt-Sandoval JA, Mendoza-Reyes JJ. El dolor agudo perioperatorio y el paracetamol: una visión basada en la evidencia. Rev Mex Anest. 2013;36:47-55.

  34. Tamayo VAC. Analgésicos no opiáceos. Inhibidores de la ciclooxigenasa. En: Guevara LUM, editor. Dolor por especialidades. México: Corinter; 2008. pp. 735-751.

  35. Allende PA, Acosta EA, Aguilar LS, Alcorta GAG, Arzate MCE, Ascencio HL, et al. Consenso Mexicano de Dolor por Cáncer. Gaceta Mexicana de Oncología. 2016;15 Supl 1:3-34.

  36. McGuiness SK, Wasiak J, Cleland H, Symons J, Hogan L, Hucker T, et al. A systematic review of ketamine as an analgesic agent in adult burn injuries. Pain Med. 2011;12:1551-1558.

  37. De Oliveira CM, Issy AM, Sakata RK. Intraoperative intravenous lidocaine. Rev Bras Anestesiol. 2010;60:325-333.

  38. Muth-Selbach U, Hermanns H, Stegmann JU, et al. Antinociceptive effects of systemic lidocaine: Involvement of spinal glycinergic system. Eur J Pharmacol. 2009;613:68-73.

  39. Wasiak J, Spinks A, Costello V, Ferraro F, Paul E, Konstantatos A, et al. Adjuvant use of intravenous lidocaine for procedural burn pain relief: A randomized double-blind, placebo-controlled, cross-over trial. Burns. 2011;37:951-957.

  40. Wasiak J, Mahar PD, McGuinness SK, et al. Intravenous lidocaine for the treatment of background or procedural burn pain. Cochr Datab Syst Rev. 2014;CD005622.

  41. Helander EM, Menard BL, Harmon CM, Homra BK, Allain, AV, Bordelon GJ, et al. Multimodal analgesia, current concepts, and acute pain considerations. Curr Pain Headache Rep. 2017;21:3.

  42. Blaudszun G, Lysakowski C, Elia N, Tramèr MR. Effect of perioperative systemic α2 agonists on postoperative morphine consumption and pain intensity: systematic review and meta-analysis of randomized controlled trials. Anesthesiology. 2012;116:1312-1322.

  43. Asmussen S, Maybauer DM, Fraser JF, Jennings K, George S, Maybauer MO. A meta-analysis of analgesic and sedative effects of dexmedetomidine in burn patients. Burns. 2012;39:625-631.

  44. Cuignet O, Pirson J, Soudon O, Zizi M. Effects of gabapentin on morphine consumption and pain in severely burned patients. Burns. 2007;33:81-86.

  45. Gray 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.

  46. Rimaz S, Alavi CE, Sedighinejad A, Tolouie M, Kavoosi S, Koochakinejad L. Effect of gabapentin on morphine consumption and pain after surgical debridement of burn wounds: a double-blind randomized clinical trial study. Arch Tauma Res. 2012;1:38-43.

  47. Wibbenmeyer L, Eid A, Liao J, Heard J, Horsefield A, Kral L, et al. Gabapentin is ineffective as an analgesic adjunct in the immediate postburn period. J Burn Care Res. 2014;35:136-142.

  48. Yuxiang L, Lingjun Z, Lu T, Mengjie L, Xing M, Fengping S, et al. Burn patients' experience of pain management: a qualitative study. Burns. 2012;38:180-186.

  49. Andrews RM, Browne AL, Wood F, Schug SA. Predictors of patient satisfaction with pain management and improvement 3 months after burn injury. J Burn Care Res. 2012;33:442-452.

  50. Provençal SC, Bond S, Rizkallah E, El-Baalbaki G. Hypnosis for burn wound care pain and anxiety: a systematic review and meta-analysis. Burns. 2018:44:1870-1881.

  51. Scheffler M, Koranyi S, Meissner W, Strauß B, Rosendahl J. Efficacy of non-pharmacological interventions for procedural pain relief in adults undergoing burn wound care: A systematic review and meta-analysis of randomized controlled trials. Burns. 2018;44:1709-1720.

  52. Pérez-Ruvalcaba I, Sánchez-Hernández V, Mercado-Sesma AR. Effect of a combined continuous and intermittent transcutaneous electrical nerve stimulation on pain perception of burn patients evaluated by visual analog scale: a pilot study. Local Reg Anesth. 2015;8:119-122.




2020     |     www.medigraphic.com