燒燙傷病患的疼痛處置

Pain Control in Burn Patients

燒燙傷是足以影響人類生命的創傷，一旦克服了生命威脅及情緒衝擊後，減輕疼痛立即成為最重要的治療議題。燒燙傷的疼痛可以分為因創傷的原始疼痛；以及因治療措施帶來的治療性疼痛，若重複性治療引發的疼痛控制不當，將帶給燒燙傷患者嚴重的心理困擾。減輕疼痛首在疼痛的客觀評估，故本文除先介紹燒燙傷傷口概況，了解燒燙傷患者的治療及疼痛概況﹔並陳述疼痛定義與理論和臨床評估疼痛的測量工具﹔最佳回顧燒傷傷口疼痛與處置，藥物治療以鴉片類止痛藥最有效，使用PCA止痛則是普遍的趨勢；非藥物類減痛措施包括按摩、冷熱敷、催眠、衛教、肌肉放鬆技巧及音樂治療，本文也引述諸多應用音樂治療的臨床成效，建議臨床醫護人員宜學習更多的疼痛控制課程，以增進住院燒燙傷患者的照護品質。

Burn injury can be regards as one of the most traumas affecting human life. Once the initial life-threate and emotional shock have been overcome, the releave of pain is the most important treatment. Burn pain was devided to background pain because skin defect and procedural pain due to therapeutic protocols. We find the repetition of highly nociceptive procedures which can lead to severe psychological disturbances if pain control is inappropriate. This article introduce the treatment and pain of burn patient, also describe the definition and theories of pain. Understanding the objective methods of pain assessment is necessary for relief pain, so this article present multiple pain assessment institude which were applicated in clinical setting or researches.This paper devided burn pain-managements into two parts which are pharmaco-therapy and non- pharmacological techniques. Pharmacotherpy with opioids is the mainstay for analgesia in burned patients, and PCA is widely accepted as an effective analgesic modality. Non- pharmacological techniques of pain control are also useful which including massage, heat therapy, hypnosis, education, muscle relaxation and music therapy. The various medical benefits of music therapy were described in this artic. This paper suggest physicians and nursing staffs should learn more pain control intervention by educational programs to increase the care satisfiaction of in-hospital burned patients.