Pain relief during dressing changes of major adult burns: Ideal analgesic combination with ketamine
Section snippets
Patients and methods
The study was conducted in the Burn Center of the Gulhane Military Medical Academy, Ankara, Turkey. Following local ethics committee approval, written informed consent was obtained from 24 patients, aged between 19 and 54 years (median: 33 years) with burns of 20–50% (median: 37%) of the total body surface area (TBSA). Only patients with flame and scald injuries were included in the study and the study group was composed of ASA physical status II and III patients. Inhalation injuries,
Results
Cardiovascular instability or respiratory depression requiring urgent intervention or oxygen supplement was not observed. There were no episodes of vomiting, laryngospasm or emergency reaction noted in either group during or after the procedure. Table 2 shows the cardiorespiratory data.
Increase in HR was observed in 52.5%, 2.5% and 13.8% of the dressing changes in groups I, II and III, respectively. The difference was found to be statistically significant (p < 0.05).
SAP increase in more than 20%
Discussion
Pain management is a critical part of treatment in acute burns. Although pain due to burn injury was well described as a major problem more than two decades ago, investigators have continued to report that burn pain remains undertreated [12], [13]. Although several treatment options have been suggested for burn pain management, it is still a challenge in a clinical setting [1], [2], [12]. As one of the main drugs, ketamine can be used both in primary and secondary hyperalgesia; it also
Conflict of interest statement
The authors have no financial and personal relationships with other people or organisations that could inappropriately influence their work.
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