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成人烧伤患者的区域麻醉和急性疼痛管理。

Regional Anesthesia and Acute Pain Management for Adult Patients with Burns.

机构信息

Department of Anesthesiology, University of Florida College of Medicine, Gainesville, Florida, USA.

出版信息

J Burn Care Res. 2023 Jul 5;44(4):791-799. doi: 10.1093/jbcr/irad069.

Abstract

Patients with burns suffer from excruciating pain, thus presenting unique challenges to the hospital staff involved in their care. Any hospital system may be involved in managing smaller and less serious burns, but patients with more complicated issues are often transferred to a burn center. This article will review the pathophysiological evolution of pain immediately after burn injury to emphasize the role of complex inflammatory pathways involved in the progression of burn pain. This review also focuses on managing acute pain using a combined multimodal and regional pain management approach. Finally, we attempt to address the continuum from acute to chronic pain management and the strategies used to minimize and manage the progression to chronic pain. Chronic pain remains a debilitating outcome of burn injury, and this article discusses efforts to mitigate this complication. Available options for pain treatment are important to discuss, as current drug shortages may limit medications that can be used.

摘要

烧伤患者会遭受剧痛,这给参与治疗的医护人员带来了独特的挑战。任何医院系统都可能会处理较小且不太严重的烧伤,但病情较复杂的患者通常会被转至烧伤中心。本文将回顾烧伤后即刻疼痛的病理生理学演变,以强调参与烧伤疼痛进展的复杂炎症途径的作用。本文还重点讨论了使用联合多模式和区域疼痛管理方法来管理急性疼痛。最后,我们尝试解决从急性到慢性疼痛管理的连续过程,以及用于最小化和管理向慢性疼痛进展的策略。慢性疼痛仍然是烧伤的一种使人衰弱的后果,本文讨论了减轻这种并发症的努力。讨论疼痛治疗的可用选择很重要,因为目前的药物短缺可能会限制可使用的药物。

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