Why Anaesthesia is not used for Patients with Burn?

Burn victims must undergo a painful debridement of their wounds in order to prevent infection. Normally, they are given morphine and other non-anesthetic pain-killers. Sadly, this does not work. They still yell in pain during the operation, which is why they have to be housed seperately from other patients.

Why aren’t the burn patients given anesthesia [local or general] prior to the operation? Is there a safety issue with anesthetics?

Reasons for not using Anaesthesia

Burn victims definitely deserve adequate pain relief at all times including during dressing change
They are grossly under-dosed in clinical practice

Anaesthetics do pose serious issues in burns patients. To name a few

Altered drug distribution – pharmacokinetics and pharmacodynamics
Prone for hypothermia
Electrolyte disturbance
Airway problem
Difficult IV access
Prone to infection & Septiciemia
Difficult to fix monitoring devices
Altered fluid distribution
Hypoproteinemia
Difficulty in transportation

All these probably lead the patient to undergo dressing changes in the ward itself.
Administering anaesthetics to these high risk patients in “out of theatre” situation may be extremely dangerous.
This  is the reason why burn patients do not get what they actually deserve.

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