Techniques and strategies for regional anesthesia in acute burn care—a narrative review

Clifford C Sheckter; Barclay T Stewart; Christopher Barnes; Andrew Walters; Paul I Bhalla; Tam N Pham

doi:10.1093/burnst/tkab015

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Techniques and strategies for regional anesthesia in acute burn care—a narrative review

更新时间：2022-06-14

- Techniques and strategies for regional anesthesia in acute burn care—a narrative review
- Techniques and strategies for regional anesthesia in acute burn care—a narrative review
- Burns & Trauma 2021年9卷第1期
- 作者机构：
  
  1. Department of Surgery
  2. University of Washington
  3. Harborview Injury Prevention and Research Center
  4. Department of Anesthesia and Pain Medicine
- 作者简介：
- 基金信息：
- DOI：10.1093/burnst/tkab015
  中图分类号：
- 纸质出版日期：2021，
  
  网络出版日期：2021-7-17，
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Clifford C Sheckter, Barclay T Stewart, Christopher Barnes, 等. Techniques and strategies for regional anesthesia in acute burn care—a narrative review[J]. Burns & Trauma, 2021,9(1).

Clifford C Sheckter, Barclay T Stewart, Christopher Barnes, Andrew Walters, Paul I Bhalla, Tam N Pham, Techniques and strategies for regional anesthesia in acute burn care—a narrative review, Burns & Trauma, Volume 9, 2021, tkab015, https://doi.org/10.1093/burnst/tkab015
Clifford C Sheckter, Barclay T Stewart, Christopher Barnes, 等. Techniques and strategies for regional anesthesia in acute burn care—a narrative review[J]. Burns & Trauma, 2021,9(1). DOI： 10.1093/burnst/tkab015.

Clifford C Sheckter, Barclay T Stewart, Christopher Barnes, Andrew Walters, Paul I Bhalla, Tam N Pham, Techniques and strategies for regional anesthesia in acute burn care—a narrative review, Burns & Trauma, Volume 9, 2021, tkab015, https://doi.org/10.1093/burnst/tkab015 DOI：

摘要

Abstract

Burn injuries and their treatments result in severe pain. Unlike traumatic injuries that are characterized by a discrete episode of pain followed by recovery

burn-injured patients endure pain for a prolonged period that lasts through wound closure (e.g. background pain

procedural pain

breakthrough pain

neuropathic pain and itch). Regional anesthesia

including peripheral nerve blocks and neuraxial/epidural anesthesia

offers significant benefits to a multimodal approach in pain treatment. A ‘regional-first’ approach to pain management can be incorporated into the workflow of burn centers through engaging regional anesthesiologists and pain medicine practitioners in the care of burn patients. A detailed understanding of peripheral nerve anatomy frames the burn clinician’s perspective when considering a peripheral nerve block/catheter. The infra/supraclavicular nerve block provides excellent coverage for the upper extremity

while the trunk can be covered with a variety of blocks including erector spinae plane and quadratus lumborum plane blocks. The lower extremity is targeted with fascia iliaca plane and sciatic nerve blocks for both donor and recipient sites. Burn centers that adopt regional anesthesia should be aware of potential complications and contraindications to prevent adverse events

including management of local anesthetic toxicity and epidural infections. Management of anticoagulation around regional anesthesia placement is crucial to prevent hematoma and nerve damage. Ultimately

regional anesthesia can facilitate a better patient experience and allow for early therapy and mobility goals that are hallmarks of burn care and rehabilitation.

关键词

Keywords

BurnRegional anesthesiaNerve blockEpiduralNerve catheterPain

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