From the Guidelines
Drug-induced burn or burning sensation should be managed with over-the-counter analgesics such as acetaminophen or NSAIDs.
Management Options
- Over-the-counter analgesics like acetaminophen or NSAIDs are well-tolerated and generally recommended for burn pain, as seen in a prospective study where 61 patients with second- or third-degree burns were randomly assigned to receive 800 mg IV ibuprofen or placebo every 6 hours with no significant incidence of serious adverse events 1.
- Ketamine is an effective drug for burn-induced pain and can limit morphine consumption, especially for short-lasting pain induced by burns or dressing changes 1.
- Short-acting opioids and inhaled nitrous oxide can be useful, especially when no intravenous access is available 1.
Non-Pharmacological Treatments
- Cooling limited burned surfaces and covering burns with a fatty substance (e.g., Vaseline and dressings) might improve pain control 1.
- Virtual reality or hypnosis techniques may reduce the intensity of pain and the patient’s anxiety 1.
Special Considerations
- Patients with severe burns, especially those involving the face, hands, feet, and genitals, or those with a large surface area, may require specialized burn center treatment due to the likely need for intravenous fluid resuscitation, surgery, and other specialized treatments 1.
From the Research
Management of Drug-Induced Burn or Burning Sensation
- The management of burn injury, including drug-induced burn or burning sensation, has seen significant advances in recent years, with a focus on proactive approaches to solve old problems 2.
- Burn pain can be managed through a combination of pharmacological and non-pharmacological interventions, including the use of opioids, local blocks, and general anesthesia, as well as non-pharmacologic approaches such as hypnosis, auricular electrical stimulation, and massage therapy 3, 4.
- The treatment of burn pain should be tailored to the individual patient's needs, taking into account the severity and type of pain, as well as the patient's medical history and other factors 3, 4, 5.
- A stepwise algorithm approach to multimodal pharmacologic management can be effective in managing burn-related pain, with combination therapies increasing efficacy and reducing toxicity 5.
- It is essential to assess burn-related pain by chronicity (acute or chronic) and type (nociceptive, neuropathic, nociplastic) to guide pharmacologic management 5.
- In some cases, surgical interventions may be necessary to manage burn-related pain, and referral to a pain management specialist may be indicated 5.