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Management of pain after burn injury

机译：烧伤后疼痛的处理

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Purpose of review: Burn pain is often under treated. Burn patients suffer from daily background pain as well as procedural pain. Direct mechanical and chemical stimulation to peripheral nociceptors, peripheral-and central sensitization contribute to the pathophysiology of pain. The purpose of this review is to discuss the current management of burn pain and also to stimulate future studies. Recent findings: Background pain is best treated with mild to moderate potent analgesics administered regularly to maintain a steady plasma drug concentration. Procedural pain should be treated vigorously with intravenous opioids, local or even general anesthesia if needed. Opioids are the mainstay of treatment for severe acute pain. PCA should be used wherever applicable. Further opioids should not be substituted by high dose NSAIDs in the management of procedural pain. Hypnosis, therapeutic touch, massage therapy, distracting techniques and other behavioral cognitive techniques have demonstrated some intriguing impact on acute as well as chronic burn pain treatment. Summary: There is no clear evidence to show that the use of opioids in acute pain may increase the likelihood of developing opioid dependency. Thus, pain after burn injury should be aggressively treated using pharmacologic and non-pharmacologic approaches. Further controlled studies are yet to be conducted to define appropriate treatments for different burn patients and to establish standard treatment protocols for burn pain.
机译：复习目的：烧伤疼痛经常得不到治疗。烧伤患者每天都会遭受背景疼痛以及程序性疼痛。对周围伤害感受器的直接机械和化学刺激，周围和中枢敏化作用促进了疼痛的病理生理。这篇综述的目的是讨论烧伤疼痛的当前治疗方法，并激发未来的研究。最近的发现：最好定期给予轻度至中度的强效镇痛药治疗背景痛，以维持稳定的血浆药物浓度。程序性疼痛应通过静脉内阿片类药物，局部麻醉或全身麻醉（如果需要）大力治疗。阿片类药物是治疗严重急性疼痛的主要手段。应在适用的地方使用PCA。在程序性疼痛的治疗中，不应用高剂量的NSAID替代其他阿片类药物。催眠，治疗性触觉，按摩疗法，分散注意力的技术和其他行为认知技术已证明对急性和慢性烧伤疼痛治疗具有一定的吸引力。摘要：没有明确的证据表明在急性疼痛中使用阿片类药物可能会增加产生阿片类药物依赖性的可能性。因此，应使用药物和非药物方法积极治疗烧伤后的疼痛。尚未进行进一步的对照研究，以定义针对不同烧伤患者的适当治疗方法，并建立烧伤疼痛的标准治疗方案。

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