Powers P S, Cruse C W, Daniels S, Stevens B A
Department of Psychiatry and Behavioral Medicine, University of South Florida College of Medicine, Tampa.
J Burn Care Rehabil. 1993 Mar-Apr;14(2 Pt 1):176-80. doi: 10.1097/00004630-199303000-00009.
Burn wound debridements requiring blunt or sharp manipulations are extremely painful even when large nonanesthetic doses of morphine are used. In this study we describe the use of debridement while the patient is under anesthesia (DUA) when manipulation of the wound is required. Seventy-one debridements were performed on 46 patients. One patient required additional fluids during the DUA, but no deaths, extensive blood losses, or significant changes in nutrition attributable to the DUA occurred. The mean number of required DUAs was 1.6 per patient compared with 6.0 per patient reported in a previous study from the same burn center that involved standard parenteral analgesic doses of morphine sulfate. Patients were completely anesthetized during the procedure. Therefore, they were free of pain and were amnestic for the experience. We conclude that DUA is a safe, efficacious procedure that permits full relief from the pain usually experienced during a manipulative burn wound debridement.
即使使用大剂量的非麻醉性吗啡，需要钝性或锐性操作的烧伤创面清创术也极其疼痛。在本研究中，我们描述了在需要对创面进行操作时，在患者麻醉状态下进行清创术（DUA）的应用情况。对46例患者进行了71次清创术。1例患者在DUA期间需要额外补液，但未发生因DUA导致的死亡、大量失血或营养状况的显著变化。每位患者所需DUA的平均次数为1.6次，而同一烧伤中心之前一项涉及标准肠外镇痛剂量硫酸吗啡的研究报告显示，每位患者所需次数为6.0次。手术过程中患者完全麻醉。因此，他们没有疼痛，且对该经历无记忆。我们得出结论，DUA是一种安全、有效的手术方法，能使患者完全免除通常在烧伤创面清创操作过程中所经历的疼痛。
