Subcutaneous adrenaline infiltration in paediatric burn surgery

Area of Science:

• Pediatric Surgery
• Anesthesiology
• Wound Healing

Background:

• Paediatric burn surgery often involves substantial blood loss and significant postoperative pain.
• Effective pain management and minimizing blood loss are critical for optimal outcomes in pediatric burn patients.

Purpose of the Study:

• To evaluate the efficacy of presurgical infiltration with adrenaline and bupivacaine in reducing blood loss and postoperative pain in children undergoing burn surgery.
• To assess the impact of this technique on graft survival and potential systemic side effects.

Main Methods:

• A prospective study of 29 children with small to medium-sized burns.
• Presurgical injection of a solution containing adrenaline (1:500,000) and bupivacaine into burn wounds and donor sites.
• Monitoring for blood transfusion requirements, systemic side effects, and pain management strategies (parenteral vs. oral analgesia).

Main Results:

• No patients required blood transfusions.
• No systemic side effects related to the injected solution were observed.
• Pain was effectively managed with oral analgesia in the majority of patients; only four required parenteral analgesia.
• Mean graft take was 95%, indicating preserved graft viability.

Conclusions:

• Presurgical infiltration with adrenaline and bupivacaine is a safe and effective method for reducing blood loss and postoperative pain in paediatric burn surgery.
• This technique does not negatively impact graft take or survival.
• It facilitates effective pain control, predominantly with oral analgesics, improving the patient experience.