Regional Anesthesia in the Burn Trauma Patient

Lovich-Sapola, Jessica A.; Alter, Jonathan A.; Baumann, Holger

doi:10.1007/s40140-020-00379-5

Cited by 1 publication

(2 citation statements)

References 13 publications

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“…The contraindications in this cohort are few, and the potential benefits are many. 5 , 11 To date there are no published clinical trials focusing on regional nerve blocks during burn dressing changes, this is likely due to a number of reasons including: perceived infection risk; poor access to experienced anesthetic clinicians and procedural equipment; focus on chronic pain interventions; and the paucity of published literature to guide a change in practice.…”

Section: Discussionmentioning

confidence: 99%

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Ultrasound-Guided Axillary Brachial Plexus Block for the Management of Graft Site Pain During Dressing Change in the Burn-Injured Patient: A Randomized Control Trial

Town

Strand

Johnson

et al. 2022

Journal of Burn Care &Amp; Research

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Burn injuries requiring split-thickness skin grafting procedures often require ongoing wound aggravation in the form of dressing changes. These dressing changes may cause significant pain due to stimulation of damaged nerve endings in the epidermal layer. A randomised control trial, pilot study, was undertaken to evaluate the impact of ultrasound-guided regional nerve block on the outcome of patient reported pain scores by inpatients requiring dressing changes for hand and upper limb burn injuries. Twenty participants aged >18 years, requiring split-skin grafting for burn injuries of <15% total body surface area were enrolled from a tertiary burns unit between August 2018 and September 2020. Participants were randomised to control (10 participants) or intervention group (10 participants). All participants received analgesia as per their treating team, the intervention group received the addition of an ultrasound-guided axillary brachial plexus block prior to their dressing change procedure. The primary outcome was to assess perceived pain at the graft site as measured by the numeric pain rating scale (0-10) before, during and after dressing change procedure. There was strong evidence of a difference in the adjusted mean change score between groups, with a mean reduction of 4.3 in the intervention group, indicating reduced pain, and a mean increase of 1.2 in the control group, (p<0.001). No adverse events occurred in either group, and the addition of ultrasound-guided regional anaesthesia for the treatment of dressing pain was determined to be a safe and effective intervention.

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Section: Discussionmentioning

confidence: 99%

“…Patients are at increased risk of developing long-term chronic pain and psychiatric trauma if acute pain is poorly managed. 11 RA is an effective primary pain management technique or adjunct to a multimodal regime. However, its application in burns is still underreported and underutilized.…”

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confidence: 99%