Centre for Children's Burns and Trauma Research, Centre for Children's Health Research, South Brisbane, QLD, Australia.
Pegg Leditschke Paediatric Burns Centre, The Queensland Children's Hospital, South Brisbane, QLD, Australia.
Paediatr Drugs. 2021 Jan;23(1):1-10. doi: 10.1007/s40272-020-00434-y. Epub 2021 Jan 15.
Appropriate pain management for children who have experienced an acute burn injury is critical to improve patient outcomes and reduce potential morbidities. With 60% of our patients being under the age of 4 years, pain management is crucial in reducing pain and anxiety in both patients and parents. It is imperative that appropriate pain relief is commenced from initial contact with healthcare workers as this will affect the success or failure of future wound procedures. Uncontrolled pain can negatively affect a patient, both short and long term. It may cause anticipatory anxiety for future medical procedures, increased pain and anxiety can decrease wound re-epithelialization which can lead to long-term consequences for growth and mobility, and increased pain can also influence the possibility of patients and families displaying signs of post-traumatic stress disorder. Pain management in the form of pharmaceuticals is imperative during burn wound treatment and should incorporate pain relief targeted at both background and procedural pain. It also requires a multimodal, individualized, and targeted approach combining both pharmaceutical and nonpharmaceutical techniques, including cold running water, multimodal distraction devices, hypnotherapy, and bubbles. We discuss the research and knowledge that our center has gained through treating pediatric patients with burns over the last 20 years.
为经历急性烧伤的儿童提供适当的疼痛管理对于改善患者预后和降低潜在发病率至关重要。我们的患者中有 60%年龄在 4 岁以下,因此,疼痛管理对于减轻患者和家长的疼痛和焦虑至关重要。从与医护人员的初次接触开始就应进行适当的疼痛缓解,这一点至关重要,因为这将影响未来伤口处理的成败。未得到控制的疼痛会对患者造成短期和长期的负面影响。它可能会引起患者对未来医疗程序的预期性焦虑,增加的疼痛和焦虑会降低伤口再上皮化的速度,从而对生长和活动能力产生长期影响,而且增加的疼痛也会影响患者和家属出现创伤后应激障碍迹象的可能性。在烧伤伤口治疗过程中,药物形式的疼痛管理至关重要,应包括针对背景和程序疼痛的缓解措施。它还需要一种多模式、个体化和有针对性的方法,结合药物和非药物技术,包括冷水冲洗、多模式分散注意力设备、催眠疗法和气泡。我们讨论了我们中心在过去 20 年中治疗小儿烧伤患者所获得的研究和知识。