Principles of Burn Pain Management

Clin Plast Surg. 2017 Oct;44(4):737-747. doi: 10.1016/j.cps.2017.05.005. Epub 2017 Jul 15.


This article describes pathophysiology of burn injury-related pain and the basic principles of burn pain management. The focus is on concepts of perioperative and periprocedural pain management with extensive discussion of opioid-based analgesia, including patient-controlled analgesia, challenges of effective opioid therapy in opioid-tolerant patients, and opioid-induced hyperalgesia. The principles of multimodal pain management are discussed, including the importance of psychological counseling, perioperative interventional pain procedures, and alternative pain management options. A brief synopsis of the principles of outpatient pain management is provided.

Keywords: Adjuvant pain medications; Alternative pain therapy; Multimodal analgesia; Opioid tolerance; Opioid-based analgesia; Opioid-induced hyperalgesia; Pain burn pathophysiology; Patient-controlled analgesia.

Publication types

  • Review

MeSH terms

  • Analgesics / therapeutic use
  • Analgesics, Opioid / administration & dosage
  • Analgesics, Opioid / therapeutic use*
  • Anesthetics / therapeutic use
  • Burns / complications
  • Burns / rehabilitation*
  • Exercise Therapy / methods*
  • Humans
  • Intraoperative Care
  • Ketamine / therapeutic use
  • Pain / etiology
  • Pain Management / methods*


  • Analgesics
  • Analgesics, Opioid
  • Anesthetics
  • Ketamine