Tratamiento del dolor en pacientes con quemaduras severas

Abstract

Severe burns are characterized by inducing the most severe and sustained metabolic response than any other form of trauma. The treatment of pain in these patients is complex. In this review, the scientific support available in the current literature was integrated from a practical clinical approach in regard to the treatment of pain in the patient with burns; in turn, two representative schemes of the classification of pain and multimodal analgesia for the patient with major burns were integrated. Multimodal analgesia is the technique currently recommended for the treatment of burn pain; however, more research is required mainly with regard to analgesic adjuvants in burned patients. It is likely that the state of intense and persistent inflammation that characterizes these patients, which implies the massive genomic reorganization of the leukocyte transcriptome, contributes to the exceptional quality of the pain of the patient with burn injuries. The foundation of successful analgesic management could be in the search for specific regulatory anti-inflammatories for these patients. It is necessary to undertake the development of effective anti-inflammatoriesanalgesics with properties that allow them to overcome the challenge of the high variability of the pharmacological parameters of the patient with major burns. Palabras clave: Quemaduras, manejo del dolor, inflamación, genómica.