This clinical review article discusses the essential aspects of the pathophysiology of paediatric burns and the effect of associated pain in the management of children with such injuries. Management of pain should be a multidisciplinary approach involving a range of professionals such as the burn surgeon, paediatrician, pain specialist (usually anaesthetist), nurse, occupational therapist, physiotherapist, psychologist, play therapist, and, importantly, the child's parents/carers. Key to successful treatment is the continuous and accurate assessment of pain, and the response to therapy. Pain has adverse physiological and emotional effects, and adequate pain control is an important factor in improving outcomes. Monitoring of pain is complicated by the traumatic nature of the initial injury and reaction to distress after a burn. For example, the potential for anticipatory pain before procedures, such as dressing changes, is high and little has been reported in the literature about chronic pain following a burn injury. Monitoring and reporting of pain in children with burns has been generally poor. Pain and distress are strongly associated with burns in children. Note that scalds in children account for more than 60% of all burn injuries. Illustration of various burn aetiologies. Both pharmacological and nonpharmacological treatment options are discussed, although a detailed review of the latter is beyond the scope and remit of this article. This clinical review article discusses the essential aspects of the pathophysiology of burns in children provides an overview of pain assessment, the salient principles in managing pain, and the essential pharmacodynamics of commonly used drugs in children with burn injuries. Key to successful treatment is the continuous and accurate assessment of pain and the response to therapy. A multidisciplinary approach is frequently necessary to achieve a robust pain relief. Due to the adverse physiological and emotional effects secondary to pain, adequate pain control is an integral and requisite component in the management of children with burns. It is acknowledged that the monitoring and reporting of pain in children with burns has generally been poor. ![]() Undertreated pain can result in noncompliance with treatment and, consequently, prolonged healing. All children with burns will experience pain, regardless of the cause, size, or burn depth. Thermal injury is the most common mechanism of injury and scalds account for >60% of such injuries.
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