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Regional Anesthesia Use in Pediatric Burn Surgery: A Descriptive Retrospective Series

Michael Richman1, Jeffrey M Berman2, Elizabeth M Ross2

  • 1Department of Pediatric Anesthesiology, Seattle Children's Hospital, Seattle, USA.

Cureus
|December 2, 2021
PubMed

Insights

Regional anesthesia effectively manages pain in pediatric burn patients, reducing opioid needs. This approach shows promise for improving recovery and minimizing complications from severe burns in children.

Area of Science:

  • Pediatric surgery
  • Pain management
  • Anesthesiology

Background:

  • Pediatric burns are a significant cause of injury, leading to painful treatments and potential long-term issues like PTSD and chronic pain.
  • Effective pain management is crucial for optimal healing and recovery in pediatric burn patients.
  • Regional anesthesia is underutilized in pediatric burn care despite its success in other pediatric surgical fields.

Purpose of the Study:

  • To evaluate the feasibility and benefits of regional anesthesia for intra-operative pain management in pediatric burn patients.
  • To assess anesthetic and opioid requirements and pain control in this patient group.

Main Methods:

  • A descriptive, retrospective case series of 15 pediatric burn patients.
  • Patients received regional anesthesia as part of their intra-operative pain management.
  • Pain was assessed using the Face, Legs, Activity, Cry and Consolability (FLACC) scale.

Main Results:

  • Low anesthetic and opioid usage was observed.
  • 93% of patients achieved a 0/10 FLACC score by post-anesthesia care unit (PACU) discharge.
  • Average PACU stay was 70 minutes, with 33% receiving no opioids and an average opioid dose of 0.06mg/kg morphine equivalents.

Conclusions:

  • Regional anesthesia is a feasible and beneficial option for pain management in pediatric burn patients undergoing operative repair.
  • This technique can lead to reduced opioid requirements and well-controlled pain.
  • Clinicians should consider regional anesthesia to improve outcomes in pediatric burn care.

Keywords:
burn graftingburn painopioid sparingpain managementpediatric anesthesiapediatric burn pain managementregional anesthesia

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