Pain Management in Burn Patients

Abstract

This review focuses on the characteristics of pain following burn injury, methods of assessment, multimodal pharmacological treatment, and non-pharmacological adjuncts. Opioid medications are the cornerstone of burn pain management protocols. Given the current opioid epidemic, current research focuses on other analgesic, anxiolytic, and sedative medications including gabapentin, ketamine, and dexmedetomidine. Non-pharmacological interventions discussed include music, massage, and more recently virtual reality and hypnosis. Further study addresses psychosocial contributions to the pain experience and associated symptoms of anxiety, sleep disturbance, and pruritus. Optimization of burn pain management requires a holistic approach and development of protocols utilizing multimodal pharmacological therapy as well as adjunctive non-pharmacological therapies. Many barriers to improved pain control exist, including inadequate education and provider bias. There is a growing need for the incorporation of mental health professionals and pain management specialists into multidisciplinary care teams.