Joubert K
Department of Surgery, Faculty of Veterinary Science, University of Pretoria, Onderstepoort, South Africa.
J S Afr Vet Assoc. 1998 Sep;69(3):95-7. doi: 10.4102/jsava.v69i3.825.
The management of pain in patients with burn wounds is complex and problematic. Burn-wound pain is severe, inconsistent and underestimated. Patients experience severe pain, especially during procedures, until wound healing has occurred. A multi-modality approach is needed for effective management of pain, which requires an understanding of the mechanisms of pain. Altered pharmacokinetics and pharmacodynamics in burn-wound patients makes drug actions unpredictable. Opioids alone are seldom sufficient for pain control. The multi-modality approach includes the use of opioids and non-steroidal anti-inflammatory, anxiolytic and alternative drugs. Ketamine has been found to be a useful agent for analgesia in burn-wound patients; a dose of 10 mg/kg qid per os was found to be an effective adjunct to pain therapy.
烧伤创面患者的疼痛管理复杂且存在问题。烧伤创面疼痛剧烈、情况不一且常被低估。患者会经历剧痛，尤其是在治疗过程中，直至创面愈合。有效的疼痛管理需要采用多模式方法，这就需要了解疼痛机制。烧伤创面患者药代动力学和药效学的改变使得药物作用难以预测。仅使用阿片类药物很少能充分控制疼痛。多模式方法包括使用阿片类药物、非甾体抗炎药、抗焦虑药和其他药物。已发现氯胺酮是烧伤创面患者镇痛的有用药物；口服剂量为10mg/kg，每日四次被发现是疼痛治疗的有效辅助手段。
