Abstract
Patients with severe burn injury are a challenge for the pediatric anesthesiologist. Today with adequate care many children survive their trauma and have a good chance for complete functional and psychological rehabilitation. The anesthesiologist has to provide excellent care even for patients in suboptimal or unstable condition to enable wound debridement and grafting, because only rapid skin closure will stabilize the patient. Adequate pain treatment during all phases of burn treatment is mandatory.
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Ashburn MA (1995) Burn pain: the management of procedurerelated pain. J Burn Care Rehabil 16: 365–371
Atchison NE, Osgood P, Carr DB, Szyfelbein S (1991) Pain during burn dressing change in children: relationship to burn area, depth and analgesic regimens. Pain 47: 41–45
Boldt J, Knothe C, Schindler E, Hammermann H, Dapper F, Hempelmann G (1993) Volume replacement with hydroxyethyl starch solution in children. Br J Anaesth 70: 661–665
Bonate PL (1990) Pathophysiology and pharmacokinetics following burn injury. Clin Pharmacokinet 18: 118–130
Bowser BH, Caldwell FT, Jr (1983) The effects of resuscitation with hypertonic vs. hypotonic vs. colloid on wound and urine fluid and electrolyte losses in severely burned children. J Trauma 23: 916–923
Brazeal BA, Honeycutt D, Traber LD, Toole JG, Herndon DN, Traber DL (1995) Pentafraction for superior resuscitation of the ovine thermal burn. Crit Care Med 23: 332–339
Calhoun KH, Deskin RW, Garza C, McCracken MM, Nichols RJ, Jr, Hokanson JA, Herndon DN (1988) Long-term airway sequelae in a pediatric burn population. Laryngoscope 98: 721–725
Carsin H (1994) Utilisation du Diprivan chez le brule [Use of diprivan in the burned patient]. Ann Fr Anesth Reanim 13: 541–544
Choiniere M, Amsel R (1994) A visual analogue thermometer: a valid and useful instrument for measuring pain in burned patients. Burns 20: 229–235
Choiniere M, Melzack R, Rondeau J, Girard N, Paquin M (1989) The pain of burns: characteristics and correlates. J Trauma 29: 1531–1539
Choiniere M, Melzack R, Girard N, Rondeau J, Paquin M-J (1990) Comparisons between patients and nurses assessment of pain and medication efficiacy in severe burn injuries. Pain 40: 143–152
Cilley RE (1992) Arterial access in infants and children. Semin Pediatr Surg 1: 174–180
Clark WR Jr (1992) Smoke inhalation: diagnosis and treatment. World J Surg 16: 24–29
Cote CJ (1996) Anesthesia for children with burns. In: Motoyama EK, Davis PJ (eds) Smith's anesthesia for infants and children. Mosby Year Book, St. Louis, pp 771–783
Cote CJ, Petkau AJ (1985) Thiopental requirements may be increased in children reanesthetized at least one year after recovery from extensive thermal injury. Anesth Analg 64: 1156–1160
Cote CJ, Liu LM, Szyfelbein SK, Goudsouzian NG, Daniels AL (1985) Changes in serial platelet counts following massive blood transfusion in pediatric patients. Anesthesiology 62: 197–201
Cote CJ, Daniels AL, Connolly M, Szyfelbein SK, Wickens CD (1992) Tongue oximetry in children with extensive thermal injury: comparison with peripheral oximetry. Can J Anaesth 39: 454–457
Demling RH, Chen C (1993) Pulmonary function in the burn patient. Semin Nephrol 13: 371–381
Demling RH, Kramer G, Harms B (1984) Role of thermal injuryinduced hypoproteinemia on fluid flux and protein permeability in burned and nonburned tissue. Surgery 95: 136–144
Dimick P, Helvig E, Heimbach D, Marvin J, Coda B, Edwards WT (1993) Anesthesia-assisted procedures in a burn intensive care unit procedure room: benefits and complications. J Burn Care Rehabil 14: 446–449
Doctor ME (1994) Parent participation during painful wound care procedures. J Burn Care Rehabil 15: 288–292
Dries DJ, Waxman K (1991) Adequate resuscitation of burn patients may not be measured by urine output and vital signs. Crit Care Med 19: 327–329
Ehrie M, Morgan AP, Moore FD, O'Connor NE (1978) Endocarditis with the indwelling balloon-tipped pulmonary artery catheter in burn patients. J Trauma 18: 664–666
Foertsch CE, O'Hara MW, Kealey GP, Foster LD, Schumacher EA (1995) A quasi-experimental, dual-center study of morphine efficacy in patients with burns. J Burn Care Rehabil 16: 118–126
Furfaro S, Gauthier M, Lacroix J, Nadeau D, Lafleur L, Mathews S (1991) Arterial catheter-related infections in children. A 1-year cohort analysis. Am J Dis Child 145: 1037–1043
Furman WR, Munster AM, Cone EJ (1990) Morphine pharmacokinetics during anesthesia and surgery in patients with burns. J Burn Care Rehabil 11: 391–394
George A, Hancock J (1993) Reducing pediatric burn pain with parent participation. J Burn Care Rehabil 14: 104–107
Gibran NS, Heimbach DM (1993) Mediators in thermal injury. Semin Nephrol 13: 344–358
Gobert E, Hartmann JF, Bougle D, Demelier JF, Beaufils F (1988) [Agglutination of intravenous lipid emulsions by acute phase proteins of inflammation] Agglutination des emulsions lipidiques intraveineuses par les proteines de la phase aigue de l'inflammadon. Pathol Biol (Paris) 36: 877–881
Goldstein B, Doody D, Briggs S (1990) Emergency intraosseous infusion in severely burned children. Pediatr Emerg Care 6: 195–197
Haburchak DR, Pruitt BA (1978) Use of systemic antibiotics in the burned patient. Surg Clin North Am 58: 1119–1132
Hennenberger A, Partecke B-D (1995) Therapie des schwerbrandverletzten Kindes aus pädiatrisch-intensivmedizinischer Sicht. Unfallchirurg 98: 193–197
Herndon DN, Langner F, Thompson P, Linares HA, Stein M, Traber DL (1987) Pulmonary injury in burned patients. Surg Clin North Am 67: 31–46
Hildreth MA, Herndon DN, Desai MH, Broemeling LD (1993) Caloric requirements of patients with burns under one year of age. J Burn Care Rehabil 14: 108–112
Housinger TA, Brinkerhoff C, Warden GD (1993) The relationship between platelet count, sepsis, and survival in pediatric burn patients Arch Surg 128: 65–67
Hu OY, Ho ST, Wang JJ, Ho W, Wang HJ, Lin CY (1993) Evaluation of gastric emptying in severe, burn-injured patients. Crit Care Med 21: 527–531
Hunt JL, Purdue GF, Gunning T (1986) Is tracheostomy warranted in the burn patient? indications and complications. J Burn Care Rehabil 7: 492–495
Kavanagh CK, Lasoff E, Eide Y (1991) Learned helplessness and the pediatric burn patient: dressing change behavior and serum cortisol and b-endorphin. Adv Pediatr 38: 335–363
Kramer GC, Nguyen T (1996) Pathophysiology of burn shock and burn edema. In: Herndon DN (ed) Total burn care. Saunders, Philadelphia, pp 44–52
Lawrence C, Atac B (1992) Hematologic changes in massive burn injury. Crit Care Med 20: 1284–1288
Levine BA, Petroff PA, Slade CL, Pruitt BA (1978) Prospective trials of dexamethasone and aerosolized gentamicin in the treatment of inhalation injury in the burned patient. J Trauma 18: 188–193
Lingnau WW, Woodson LC, Nichols RJ, et al (1996) Anesthesia for burned patients. In: Herndon DN (ed) Total burn care. Saunders, Philadelphia, pp 148–157
Lyons B, Casey W, Doherty P, McHugh M, Moore KP (1996) Pain relief with low-dose intravenous clonidine in a child with severe burns. Intensive Care Med 22: 249–251
Maciewicz R, Bouckoms A, Martin JB (1985) Drug therapy of neuropathic pain. Clin J Pain 1: 39–49
Maron M, Bush J (1992) Brn injury and treatment pain. In: Anonymous children in pain. pp 275–293
Martyn J (1986) Clinical pharmacology and drug therapy in the burned patient. Anesthesiology 65: 67–75
Martyn JA (1987) Burn care protocols: administration of ketamine. Ketamine pharmacology and therapeutics. J Burn Care Rehabil 8: 146–148
Martyn JA, Szyfelbein SK (1990) Anesthetic management of the burned patient. In: Martyn JA (ed) Acute management of the burned patient. Saunders, Philadelphia, pp 217–230
Martyn J, Goldhill DR, Goudsouzian NG (1986) Clinical pharmacology of muscle relaxants in patients with burns. J Clin Pharmacol 26: 680–685
Marvin JA, Heimbach DM (1985) Pain control during the intensive care phase of burn care. Crit Care 1: 147–157
McCaughey TJ (1962) Hazards of anaesthesia for the burned child. Can Anaesth Soc J 220–233
McGrath PJ, Vair C (1984) Psychological aspects of pain management of the burned child. Childrens Health Care 13: 15–19
Merrell SW, Saffle JR, Sullivan JJ, Navar PD, Kravitz M, Warden GD (1986) Fluid resuscitation in thermally injured children. Am J Surg 152: 664–669
Meuli M, Lochbuhler H (1992) Current concepts in pediatric burn care: general management of severe burns. Eur J Pediatr Surg 2: 195–200
Moiniche S, Pedersen JL, Kehlet H (1994) Topical ketorolac has no antinociceptive or anti-inflammatory effect in thermal injury. Burns 20: 483–486
Murat I, Billard V, Vemois J, Zaouter M, Marsol P, Souron R, Farinotti R (1996) Pharmacokinetics of propofol after a single dose in children aged 1–3 years with minor burns. Comparison of three data analysis approaches. Anesthesiology 84: 526–532
O'Leary RJ Jr, Landon M, Benumof JL (1992) Buccal pulse oximeter is more accurate than finger pulse oximeter in measuring oxygen saturation. Anesth Analg 75: 495–498
Osgood P, Szyfelbein S (1989) Management of burn pain in children. Pediatr Clin North Am 36: 1001–1013
Patterson DR (1995) Non-opioid-based approaches to burn pain. J Burn Care Rehabil 16: 372–376
Pedersen JL, Moiniche S, Kehlet H (1994) Topical glucocorticoid has no antinociceptive or anti-inflammatory effect in thermal injury. Br J Anaesth 72: 379–382
Pedersen JL, Callesen T, Moiniche S, Kehlet H (1996) Analgesic and anti-inflammatory effects of lignocaine-prilocaine (EMLA) cream in human burn injury. Br J Anaest 76: 806–810
Perry S, Heidrich G (1982) Management of pain during debridement: a survey of U. S. burn units. Pain 13: 267–280
Perry S, Heidrich G, Ramos E (1981) Assessment of pain by burn patients. J Burn Care Rehabil 2: 322–326
Powers PS, Cruse CW, Daniels S, Stevens BA (1993) Safety and efficacy of debridement under anesthesia in patients with burns. J Bum Care Rehabil 14: 176–180
Robinson NB, Hudson LD, Riem M (1982) Steroid therapy following isolated smoke injury. J Trauma 22: 876–879
Sasaki TM, Panke TW, Dorethy JF, Lindberg RB, Pruitt BA (1979) The relationship of central venous and pulmonary artery catheter position to acute right-sided endocarditis in severe thermal injury. J Trauma 19: 740–743
Satwicz PR, Martyn JA (1987) The burn-injured child: anesthetic management. Resident Staff Physician 32: 45–51
Sheridan RL, Weber JM, Tompkins RG (1994) Femoral arterial catheterization in paediatric burn patients. Burns 20: 451–452
Szyfelbein SK, Martyn JA, Cote CJ (1993) Burn injuries. In: Ryan JF, Todres DI, Cote CJ, Goudsouzian NG (eds) A practice of anesthesia for infants and children. Saunders, Philadelphia, pp 357–376
Trop M, Carter EA, Schiffrin EJ, Tompkins RG (1994) Arterial blood pressure immediately after thermal injury: the role of anesthesia. J Burn Care Rehabil 15: 224–231
Turbow ME (1973) Abdominal compression following circumferential burn: cardiovascular responses. J Trauma 13: 535–541
Wagner BK, D'Amelio LF (1993) Pharmacologic and clinical considerations in selecting crystalloid, colloidal, and oxygencarrying resuscitation fluids, part 1. Clin Pharm 12: 335–346
Warden G (1996) Fluid resuscitation and early management. In: Herndon DN (ed) Total burn care. Saunders, Philadelphia, pp 53–60
Warden GD (1992) Burn shock resuscitation. World J Surg 16: 16–23
Wolfe RR (1993) Metabolic response to burn injury: nutritional implications. Keio J Med 42: 1–8
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Beushausen, T., Mücke, K. Anesthesia and pain management in pediatric burn patients. Pediatr Surg Int 12, 327–333 (1997). https://doi.org/10.1007/BF01076931
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DOI: https://doi.org/10.1007/BF01076931