Pietermaritzburg Burn Service, Pietermaritzburg Metropolitan Department of Surgery, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa; and, Developing Research, Innovation, Localization and Leadership (DRILL), College of Health Sciences, University of KwaZulu-Natal, Durban.
S Afr Fam Pract (2004). 2021 Feb 23;63(1):e1-e7. doi: 10.4102/safp.v63i1.5193.
Despite the exceptional burden of burns in low- and middle-income countries (LMIC) and the importance of adequate analgesia in burn care, there is a lack of analgesia protocol developed in resource-scarce settings. This necessitates the development of an analgesia protocol applicable to the resource-scarce setting. This study presents the findings of a modified Delphi study aimed at achieving consensus by a panel of experts in the management of burn injuries from low- and middle-income settings across Africa.
A two-round Delphi survey was conducted to achieve consensus on an analgesia protocol for paediatric burn patients for a resource-limited setting. The Delphi panel consisted of nine experts with experience in management of burn injuries in low-income settings.
Consensus was determined by an a priori threshold of 80% of agreement for a drug to be included in the analgesia protocol. There was a largely overarching agreement with regard to the background analgesia protocol and strong agreement regarding the use of an initial dose of ketamine and midazolam for procedural sedation.
A modified Delphi method was used to obtain expert consensus for a recently adopted analgesia protocol for burn-injured children in a resource-limited setting, with experts in the management of burn injuries in low- and middle-income settings. The expert consensus leads to the rigour and robustness of the protocol. Delphi methods are exceptionally valuable in healthcare research and the aim of such studies is to find converging expert opinions.
尽管中低收入国家（LMIC）的烧伤负担异常沉重，并且在烧伤护理中充分镇痛非常重要，但在资源匮乏的环境中缺乏开发的镇痛方案。这就需要开发一种适用于资源匮乏环境的镇痛方案。本研究介绍了一项修改后的德尔菲研究的结果，该研究旨在通过来自非洲中低收入环境的烧伤管理专家小组达成共识。
进行了两轮德尔菲调查，以就资源有限环境中儿科烧伤患者的镇痛方案达成共识。德尔菲小组由九名在低收入环境中管理烧伤经验的专家组成。
通过事先设定的 80%的药物纳入镇痛方案的协议达成共识的阈值来确定共识。在背景镇痛方案方面存在广泛的总体协议，并且对使用氯胺酮和咪达唑仑进行初始剂量的程序镇静有强烈的协议。
使用修改后的德尔菲方法在资源有限的环境中为烧伤儿童获得了最近采用的镇痛方案的专家共识，这些专家在中低收入环境中管理烧伤。专家共识导致了方案的严谨性和稳健性。德尔菲方法在医疗保健研究中非常有价值，此类研究的目的是找到趋同的专家意见。
