ADJUNCTIVE METHODS OF PAIN CONTROL IN BURNS

Opiates remain the most common form of analgesic therapy in the burn p atient today. Because of increased opiate requirements, optimal relief of burn pain continues to be a problem for these patients. The purpos e of this article is to summarize those alternative pain control metho ds that appear in the literature. For instance, in minor burns acetomi nophen continues to he a useful first line analgesic. Non-steroidal an ti-inflammatory drugs (NSAID) and benzodiazepine are generally combine d with opiates while entonox seems to be used commonly in the adolesce nt patients to relieve procedural pain. Antidepressants appear to enha nce opiate-induced analgesia while anticonvulsants are useful in the t reatment of sympathetically maintained pain following bums. Ketamine h as been extensively used during burn dressing changes but its psycholo gical side-effects have limited its use. Clonidine, however, has shown promise in reducing pain without causing pruritus or respiratory depr ession. Other forms such as transcutaneous electrical nerve stimulatio n (TENS), psychological techniques, topical and systemic local anaesth etics are also useful adjuncts. (C) 1997 Elsevier Science Ltd for ISBI .