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Published on: June 2, 2022

Reviewing the Safety of Providing Out of Operating Room Anesthesia for Acute Burns in Pediatric Patients

Sabrina Yang1, Sara Faour2, Farrukh Munshey3

  • 1University of Ottawa, Faculty of Medicine, Ottawa ON, K1H 8M5, Canada.

Journal of Burn Care & Research : Official Publication of the American Burn Association
|July 8, 2026
PubMed

Insights

Expanding anesthesia eligibility for younger, smaller pediatric burn patients undergoing burn dressing changes outside the operating room (OR) is safe and effective. This approach maintains procedural efficiency and positive patient outcomes.

Area of Science:

  • Pediatric Anesthesiology
  • Burn Care Management
  • Patient Safety Protocols

Background:

  • Effective pain management is crucial in pediatric burn care, often necessitating sedation or anesthesia for burn wound procedures.
  • Anesthesia outside the operating room (OR) offers a safe alternative, but historically excluded younger or smaller children.
  • A 2022 quality audit expanded eligibility for out-of-OR anesthesia to include infants aged 8-12 months and/or weighing 8-10 kg.

Purpose of the Study:

  • To compare quality and safety indicators for out-of-OR anesthesia in pediatric burn patients meeting expanded versus historical eligibility criteria.
  • To evaluate the feasibility and impact of broadened anesthesia access for burn dressing changes.
  • To assess outcomes including procedure duration, anesthetic techniques, and complications.

Main Methods:

  • Single-center retrospective study of pediatric burn patients (January 2022 - January 2024).
  • Comparison of patients meeting expanded criteria (8-12 months/8-10 kg) versus historical criteria (>10 kg/>12-24 months).
  • Analysis of procedure duration, anesthetic management, airway interventions, complications, and post-procedure disposition.

Main Results:

  • No significant differences in burn characteristics between groups; scalds and partial-thickness burns were most common.
  • No oxygen desaturation, hemodynamic instability, airway obstruction, or difficult mask ventilation occurred.
  • One instance of laryngospasm in the expanded group resolved conservatively; procedure duration was shorter in this group.

Conclusions:

  • Expanding eligibility for anesthesiologist-administered out-of-OR anesthesia in pediatric burn patients is safe and feasible.
  • This expansion does not negatively impact procedural efficiency or patient safety outcomes.
  • Out-of-OR anesthesia can be successfully implemented for younger and smaller pediatric burn patients requiring burn dressing changes.

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