Romanowski KS, Carson J, Pape K, Bernal E, Sharar S, Wiechman S, Carter D, Liu YM, Nitzschke S, Bhalla P, Litt J, Przkora R, Friedman B, Popiak S, Jeng J, Ryan CM, Joe V, et al.
Journal of burn care & research : official publication of the American Burn Association. Date of publication 2020 Nov 30;volume 41(6):1129-1151.
1. J Burn Care Res. 2020 Nov 30;41(6):1129-1151. doi: 10.1093/jbcr/iraa119.
American Burn Association Guidelines on the Management of Acute Pain in the Adult
Burn Patient: A Review of the Literature, a Compilation of Expert Opinion, and
Next Steps.
Romanowski KS(1), Carson J(2), Pape K(3), Bernal E(4), Sharar S(5), Wiechman
S(5), Carter D(6), Liu YM(7), Nitzschke S(8), Bhalla P(5), Litt J(9), Przkora
R(10), Friedman B(11), Popiak S(12), Jeng J(13), Ryan CM(14), Joe V(15).
Author information:
(1)University of California, Davis and Shriners Hospitals for Children Northern
California, Sacramento, California.
(2)University of Florida Health Shands Burn Center, Gainesville, Florida.
(3)University of Iowa Hospitals and Clinics, Iowa City, Iowa.
(4)Kendall Regional Medical Center, Miami, Florida.
(5)University of Washington School of Medicine, Harborview Medical Center,
Seattle Washington.
(6)Maine Medical Center, Portland, Maine.
(7)Loyola University Medical Center, Maywood, Illinois.
(8)Brigham and Women's Hospital, Boston, Massachusetts.
(9)University of Missouri School of Medicine, Columbia, Missouri.
(10)University of Florida Health, Anesthesiology and Pain Medicine, Gainesville,
Florida.
(11)JM Still Burn Center, Augusta, Georgia.
(12)Shriners Hospitals for Children-Galveston, Galveston, Texas.
(13)Nathan Speare Regional Burn Treatment Center Crozer Chester Medical Center,
Upland, Pennsylvania.
(14)Department of Surgery, Massachusetts General Hospital, Harvard Medical
School, and Shriners Hospitals for Children-Boston®, Boston, Massachusetts.
(15)University of California Irvine Regional Burn Center, Orange, California.
The ABA pain guidelines were developed 14 years ago and have not been revised
despite evolution in the practice of burn care. A sub-committee of the American
Burn Association's Committee on the Organization and Delivery of Burn Care was
created to revise the adult pain guidelines. A MEDLINE search of English-language
publications from 1968 to 2018 was conducted using the keywords "burn pain,"
"treatment," and "assessment." Selected references were also used from the
greater pain literature. Studies were graded by two members of the committee
using Oxford Centre for Evidence-based Medicine-Levels of Evidence. We then met
as a group to determine expert consensus on a variety of topics related to
treating pain in burn patients. Finally, we assessed gaps in the current
knowledge and determined research questions that would aid in providing better
recommendations for optimal pain management of the burn patient. The literature
search produced 189 papers, 95 were found to be relevant to the assessment and
treatment of burn pain. From the greater pain literature 151 references were
included, totaling 246 papers being analyzed. Following this literature review, a
meeting to establish expert consensus was held and 20 guidelines established in
the areas of pain assessment, opioid medications, nonopioid medications, regional
anesthesia, and nonpharmacologic treatments. There is increasing research on pain
management modalities, but available studies are inadequate to create a true
standard of care. We call for more burn specific research into modalities for
burn pain control as well as research on multimodal pain control.
© American Burn Association 2020. All rights reserved. For permissions, please
e-mail: journals.permissions@oup.com.
DOI: 10.1093/jbcr/iraa119
PMCID: PMC7703676 [Available on 2021-09-04]
PMID: 32885244
