Anesthesia for Major Thermal Injury

Can Succinylcholine be Used Safely in Severely Burn Patients?

“…Rebecca M. Huggins et al 2 found administration of succinylcholine to patients without neuromuscular disease results in a small transient increase in a serum potassium (k+) concentration of about .55 mEq/l and serum potassium (k+) increase greater than 5 mEq/l are extremely rare. Maclennan et al 11 suggest that succinylcholine should not be used beyond 24 hours after a burn injury. However there are no reports in the literature of succinylcholine induced hyperkalemia in human occurring within 1 week after burn injury.…”

Das Verbrennungstrauma –Teil 2

“…Diese Sensibilisierung gegenüber depolarisierenden Muskelrelaxanzien kann in Abhängigkeit von der Dauer sowie dem Ausmaß der körperlichen Rehabilitation und dem Grad der Immobilisation mehrere Monate anhalten [17,25,48]. Der Bedarf an nichtdepolarisierenden Relaxanzien zur kompletten Muskelerschlaffung ist um das 2-bis 5-Fache gesteigert [15,43]. Der Opioidbedarf ist stark erhöht.…”

Current advances in the initial management of major thermal burns

“…In contrast, the extreme pain of a second-degree burn requires analgesia. In conscious patients with spontaneous breathing, morphine is generally necessary to maintain adequate initial pain control [5]. The anxiety caused by an extensive burn often justifies the addition of low doses of benzodiazepines [43].…”

“…Table 1 (adapted from [5]) lists criteria that can be used to define a ªma-jorº burn. Recent publications have suggested that survival rates now reach 50 % in young adults sustaining a total body surface area (TBSA) burn of 80 % without inhalational injury [6,7].…”