Analgesia For Dressing Changes In Burns: A Systematic Review

Abstract

Background: Intense and prolonged pain often caused by burn injuries. The greatest pain is mostly experienced during dressing changes to maintain healing and banish the infection. This review is conducted to assess the effectiveness and safety of different analgesia agents or methods for dressing changes in burn patients. Method: Searches of studies conducted from 4 electronic databases, using keywords “Analgesia”, “Dressing”, “Bandages”, “Changes” and “Burns”. We included randomized and quasi-randomized trials assessing and comparing the effects of different analgesia agents, analgesia methods for dressing changes in burns patients. We excluded trials reporting only pharmacokinetic and physiological outcomes, comparing drug dosages, with exception for those using different drugs in the same class. Result: Multiple databases search retrieved 144 studies. 17 trials are eligible involving 700 patients. Analgesia using pharmacological agents in 7 trials; 5 trials elaborating primary treatments and 2 trials as the adjunct treatment complementing the major analgesia. Two primary analgesia treatments were studying the role of patient-controlled analgesia (PCA), while 3 trials using caregiver delivered. Ten trials were observing the role of non-pharmacological analgesia. Conclusion: There was inadequate evidence from comparisons tested in randomized trials to confirm the dependent effectiveness of various techniques of analgesia, individual methods, or to assess the administration of different drug adjuncts for providing analgesia during dressing changes. Given the unresolved questions about the management of these conditions, we suggest that preference should be focused on the large scale, optionally, multi-center randomized observations of the primary methods.