Analgesic protocol for procedural pain treatment of second-degree burns in children

Abstract

Background / Aim. Children with burns are submitted to multiple, painful and anxiety related procedures during wound dressing, treatment, and rehabilitation. The objective of analgesic treatments for procedural pain is the safe and efficient management of pain and emotional stress, which requires a careful, balanced, and systematic approach. The goal of this study was to determine the effectiveness of analgesic and/or local anestetic on relieving the intensity of procedural pain. Methods. In the study, 120 pediatric patients with second-degree burns were allocated into four groups of 30. During wound dressings, patients in the control group did not receive any analgesics, while in the remaining groups 30 minutes prior to wound dressing, oral nonsteroidal anti-inflammatory drug, local anesthetic, or both were administered. Results. The average visual analog scale (VAS) score in the control group was statistically significantly higher on all tested days in comparison with children in all groups who were treated. On the first test day, all children had high VAS values and the limit was 89.50/100. There was a remarkable difference on the fifth day of dressing with the limit of 57.50/100, and on the seventh day the limit was 43.50/100. Children who experienced the lowest intensity of pain during dressing changes of burn wounds for all test days were those in the group who recieved both systemic analgesic and local anesthetic. Conclusion. The study confirmed the importance of the introduction of complex polymodal protocol in the treatment of procedural pain in second degree burns. The protocol should include analgesics as well as anesthetics since they both contribute in achieving the best results in pain reduction and treatment outcome.