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Pain management after burn trauma

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Handbook of Burns

Abstract

Pain after burn injuries is one of the most severe forms of acute pain. Although wound and pain management have gradually improved over the last years, a sufficient pain management after severe burn trauma is still a global problem and a major challenge for the health care personnel.

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References

  1. Kehlet H, Jensen TS, Woolf CJ (2006) Persistent postsurgical pain: risk factors and prevention. The Lancet 367: 1618–1625

    Article  Google Scholar 

  2. Dauber A, Osgood PF, Breslau AJ et al (2002) Chronic persistent pain after severe burns: a survey of 358 burn survivors. Pain Med 3: 6–17

    Article  PubMed  Google Scholar 

  3. Ratcliff SL, Brown A, Rosenberg L et al (2006) The effectiveness of a pain and anxiety protocol to treat the acute pediatric burn patient. Burns 32(5): 554–562

    Article  PubMed  Google Scholar 

  4. Spacek A (2006) Der neuropathische Schmerz — aktuelle Therapiekonzepte. 1. Aufl. UNI-MED Verlag AG Bremen S. 20–23

    Google Scholar 

  5. Gray P, Williams B, Cramond T (2008) Successful use of Gabapentin in acute pain management following burn injury: a case series. Pain Med 9 (3): 371–376

    Article  PubMed  Google Scholar 

  6. Malenfant A, Forget R, Papillon J et al (1996) Prevalence and characteristics of chronic sensory problems in burn patients. Pain 67(2–3): 493–500

    Article  PubMed  CAS  Google Scholar 

  7. Choiniere M, Melzack R, Papillon J (1991) Pain and paresthesia in patients with healed burns: An exploratory study. J Pain Symptom Manage 6(7): 437–444

    Article  PubMed  CAS  Google Scholar 

  8. Macrae WA (2001) Chronic pain after surgery. Br J Anaesth 87: 88–98

    Article  PubMed  CAS  Google Scholar 

  9. Thomans CR, Brazeal BA, Rosenburg L et al (2003) Phantom limb pain in pediatric burns survivors. Burns 29(2): 139–142

    Article  Google Scholar 

  10. Kumbhat S, Meyer N, Schurr MJ (2004) Complex regional pain syndrome as a complication of a chemical burn to the foot. J Burn Care Rehabil 25(2): 189–191

    Article  PubMed  CAS  Google Scholar 

  11. Van der Laan L, Goris RJA (1996) Reflex sympathetic dystrophy after burn injury. Burns 22(4): 303–306

    Article  PubMed  Google Scholar 

  12. Isakov E, Boduragin N, Korzets A, Susak Z (1995) Reflex sympathetic dystrophy of both patellae following burns. Burns 21(8): 616–618

    Article  PubMed  CAS  Google Scholar 

  13. Kim CT, Bryant P (2001) Complex regional pain syndrome (type I) after electrical injury: A case report of treatment with continuous epidural block. Arch Phys Med Rehabil 82(7): 993–995

    Article  PubMed  CAS  Google Scholar 

  14. Melzack R (1975) The McGill pain questionnaire: major properties and scoring methods. Pain 1: 277–299

    Article  PubMed  CAS  Google Scholar 

  15. Payen JF, Bru O, Bosson JL et al (2001) Assessing pain in critically ill sedated patients by using a behavioral pain scale. Crit Care Med 29(12): 2258–2263

    Article  PubMed  CAS  Google Scholar 

  16. Abbey J, Piller N, De Bellis A et al (2004) The Abbey Pain Scale: a 1-minute numerical indicator for people with end-stage dementia. Int J Palliative Nurs 10(1): 6–13

    Google Scholar 

  17. Merkel SI, Voepel-Lewis T, Shayevitz JR, Malviya S (1997) The FLACC: a behavioral scale for scoring postoperative pain in young children. Paediatr Nurs 23(3): 293–297

    CAS  Google Scholar 

  18. Büttner W et al (1998) Entwicklung eines Fremdbeobachtungsbogens zur Beurteilung des postoperativen Schmerzes bei Säuglingen. AINS 33: 353–361

    PubMed  Google Scholar 

  19. Taal LA, Faber AW, Van Loey NEE et al (1999) The abbreviated burn specific pain anxiety scale: a multicenter study. Burns 25(6): 493–497

    Article  PubMed  CAS  Google Scholar 

  20. Rae CP, Gallagher D, Watson S, Kinsella J (2000) An audit of patient perception compared with medical and nursing staff estimation of pain during burn dressing changes. Eur J Anaesthesiol 17(1): 43–45

    PubMed  CAS  Google Scholar 

  21. Pallua N (2009) Kompendium der Schmerztherapie bei Verbrennungen. Deutsche Gesellschaft für Verbrennungsmedizin und Deutsche Gesellschaft zum Studium des Schmerzes. URL: http://www.dgss.org/filead min/pdf/Schmerz_KompendiumVerbrennung0901. pdf

    Google Scholar 

  22. Barden J, Edwards J, Moore RA, MyQuay HJ (2004) Single dose oral diclofenac for postoperative pain. Cochrane Database Syst Rev(2): CD004 768

    Google Scholar 

  23. Elia N, Lysakowski C, Tramer MR (2005) Does multimodal analgesia with acetaminophen, nonsteroidal anti-inflammatory drugs, or selective cyclooxygenase-2 inhibitors and patient-controlled analgesia morphine offer advantages over morphine alone? Anesthesiology 103: 1296–1304

    Article  PubMed  CAS  Google Scholar 

  24. Koppert W, Wehrfritz A, Korber N et al (2004) The cyclooxygenase isoenzyme inhibitors parecoxib and paracetamol reduce central hyperalgesia in humans. Pain 108: 148–153

    Article  PubMed  CAS  Google Scholar 

  25. Tröster A, Sittl R, Singer B et al (2006) Modulation of remifentanil-induced analgesia and postinfusion hyperalgesia by parecoxib in humans. Anesthesiology 105: 1016–1023

    Article  PubMed  Google Scholar 

  26. Pelissier T, Alloui A, Caussade F et al (1996) Paracetamol exerts a spinal antinociceptive effect involving an indirect interaction with 5-hydroxytryptamine3 receptors: in vivo and in vitro evidence. J Pharm Exp Ther 278: 8–14

    CAS  Google Scholar 

  27. Beubler E (2009) Kompendium der medikamentösen Schmerztherapie, 4. Aufl. Springer Wien New York, S 19

    Book  Google Scholar 

  28. Larsen R (2001) Anästhesie, 7. Aufl. Urban und Fischer Verlag, München, S 806

    Google Scholar 

  29. Kramer MS, Lane DA, Hutchinson TA (1988) The International Agranulocytosis and Aplastic Anemia Study (IAAAS). J Clin Epidemiol 41 (6): 613–616

    Article  PubMed  CAS  Google Scholar 

  30. Hedenmalm K, Spigset O (2002) Agranulocytosis and other blood dyscrasias associated with dipyrone (metamizole). Eur J Clin Pharmacol 58(4): 265–274

    Article  PubMed  CAS  Google Scholar 

  31. Ott E, Nussmeier NA, Dukie PC et al (2003) Efficacy and safety of the cyclooxygenase 2 inhibitors parecoxib and valdecoxib in patients undergoing coronary artery bypass surgery. J Thorac Cardiovasc Surg 125(6): 1481–192

    Article  PubMed  CAS  Google Scholar 

  32. McGettigan P, Henry D (2006) Cardiovascular risk and inhibition of cyclooxygenase. A systematic review of the oberservational studies of selective and nonselective inhibitors of cyclooxygenase2. JAMA 296(13): 1633–1644

    Article  PubMed  CAS  Google Scholar 

  33. Nussmeier NA, Whelton AA, Brown MT et al (2005) Complications of the COX-2 inhibitors parecoxib and valdecoxib after cardiac surgery. N Engl J Med 352: 1081–1091

    Article  PubMed  CAS  Google Scholar 

  34. Freye E, Latasch L (2003) Development of opioid tolerance — molecular mechanisms and clinical consequences. AINS 38: 14–26

    PubMed  CAS  Google Scholar 

  35. Koppert W, Sittl R, Scheuber K et al (2003) Differential modulation of remifentanil-induced analgesia and postinfusion hyperalgesia by s-ketamine and clonidine in humans. Anesthesiology 99(1): 152–159

    Article  PubMed  CAS  Google Scholar 

  36. Célèrier E, Rivat C, Jun Y et al (2000) Long-lasting hyperalgesia Induced by Fentanyl in rats. Anesthesiology 92(2): 465–472

    Article  PubMed  Google Scholar 

  37. Xiangqi Li, Angst MS, Clark JD (2001) Opioid-induced hyperalgesia and incisional pain. Anesth Analg 93: 204–209

    Google Scholar 

  38. Joly V, Richebe Ph, Guignard B et al (2005) Remifentanil-induced postoperative hyperalgesia and its prevention with small-dose ketamine. Anesthesiology 103(1): 147–155

    Article  PubMed  CAS  Google Scholar 

  39. Smith MT, Watt JA et al (1990) Morphine-3-glucoronide — a potent antagonist of morphine analgesia. Life Sci 47: 579–585

    Article  PubMed  CAS  Google Scholar 

  40. Stamer UM, Lehnen K, Höthker F et al (2003) Impact of CYP2D6 genotype on postoperative tramadol analgesia. Pain 105: 231–238

    Article  PubMed  CAS  Google Scholar 

  41. Duhmke RM, Cornblath DD, Hollingshead JR (2004) Tramadol for neuropathic pain. Cochrane Database Syst Rev(2): CD003 726

    Google Scholar 

  42. Tosun Z, Esmaoglu A, Coruh A (2008) Propofol-ketamine vs propofol-fentanyl combinations for deep sedation and analgesia in pediatric patients undergoing burn dressing changes. Pediatric Anesthesia 18: 43–47

    PubMed  Google Scholar 

  43. Linneman PK, Terry BE, Burd RS (2000) The efficacy and safety of fentanyl for the management of severe procedural pain in patients with burn injuries. J Burn Care Rehabil 21(6): 519–522

    Article  PubMed  CAS  Google Scholar 

  44. Prakash S, Fatima T, Pawar M (2004) Patient-controlled analgesia with fentanyl for burns dressing changes. Anesth Analg 99(2): 552–555

    Article  PubMed  CAS  Google Scholar 

  45. Ong EC (2008) Controlled-release oxycodone in the treatment of neuropathic pain of nonmalignant and malignant causes. Oncology 74(1): 72–75

    Article  PubMed  CAS  Google Scholar 

  46. Gatti A, Sabato AF, Occhioni R et al (2009) Controlledrelease oxycodone and pregabalin in the treatment of neuropathic pain: results of a multicenter Italian study. Eur Neurol 61(3): 129–137

    Article  PubMed  CAS  Google Scholar 

  47. Altier N, Dion D, Boulanger A, Choiniere M (2001) Successful use of methadone in the treatment of chronic neuropathic pain arising from burn injuries: a casestudy. Burns 27(7): 771–775

    Article  PubMed  CAS  Google Scholar 

  48. Subramaniam K, Subramaniam B, Steinbrook RA (2004) Ketamine as adjuvant analgesic to opioids: a quantitative and qualitative systematic review. Anesth Analg 99: 482–495

    Article  PubMed  CAS  Google Scholar 

  49. Mao J, Price DD, Mayer GJ (1995) Mechanisms of hyperalgesia and morphine tolerance: a current view of their possible interactions. Pain 62: 259–274

    Article  PubMed  CAS  Google Scholar 

  50. Weinbroum AA, Gorodezky A, Niv D et al (2001) Dextromethorphan attenuation of postoperative pain and primary and secondary thermal hyperalgesia. Can J Anaesth 48: 167–174

    Article  PubMed  CAS  Google Scholar 

  51. Weinbroum AA (2003) A single small dose of postoperative ketamine provides rapid and sustained improvement in morphine analgesia in the presence of morphine-resistant pain. Anesth Analg 96: 789–795

    Article  PubMed  CAS  Google Scholar 

  52. Bell R, Dahl J, Moore R, Kalso E (2006) Perioperative ketamine for acute postoperative pain. Cochrane Database Syst Rev (1):CD004 603

    Google Scholar 

  53. De Kock M, Lavand’homme P, Waterloos H (2001) Balanced analgesia in the perioperative period: is there a place for ketamine? Pain 92: 373–380

    Article  PubMed  Google Scholar 

  54. Lavand’homme P, De Kock M, Waterloos H (2005) Intraoperative epidural analgesia combined with ketamine provides effective preventive analgesia in patients undergoing major digestive surgery. Anesthesiology 103: 813–820

    Article  CAS  Google Scholar 

  55. Owens VF, Palmieri TL, Comroe CM et al (2006) Ketamine: A safe and effective agent for painful procedures in the pediatric burn patient. J Burn Care Res 27(2): 211–216

    Article  PubMed  Google Scholar 

  56. Menigaux C, Adam F, Guignard B et al (2005) Preoperative gabapentin decreases anxiety and improves early functional recovery from knee surgery. Anesth Analg 100: 1394–1399

    Article  PubMed  CAS  Google Scholar 

  57. Pollack MH, Matthews J, Scott EL (1998) Gabapentin as a potential treatment for anxiety disorders. Am J Psychiatry 155: 992–993

    PubMed  CAS  Google Scholar 

  58. Chouinard G, Beauclair L, Belanger MC (1998) Gabapentin: long-term antianxiety and hypnotic effects in psychiatric patients with comorbid anxiety-related disorders. Can J Psychiatry 43: 305

    PubMed  CAS  Google Scholar 

  59. Eckhardt K, Ammon S, Hofmann U et al (2000) Gabapentin enhances the analgesic effect of morphine in healthy volunteers. Anesth Analg 91: 185–191

    PubMed  CAS  Google Scholar 

  60. Field MJ, Oles RJ, Lewis AS et al (1997) Gabapentin (neurontin) and S-(+)-3-isobutylgaba represent a novel class of selective antihyperalgesic agents. Br J Pharmacol 121(8): 1513–1522

    Article  PubMed  CAS  Google Scholar 

  61. Cuignet O, Pirson J, Soudon O, Zizi M (2007) Effects of gabapentin on morphine consumption and pain in severely burned patients. Burns 33(1): 81–86

    Article  PubMed  Google Scholar 

  62. Mendham JE et al (2004) Gabapentin for the treatment of itching produced by burns and wound healing in children: a pilot study. Burns 30: 851–853

    Article  PubMed  CAS  Google Scholar 

  63. Pal SK, Cortiella J, Herndon D (1997) Adjunctive methods of pain control in burns. Burns 23(5): 404–412

    Article  PubMed  CAS  Google Scholar 

  64. Tcheung WJ, Robert R, Rosenberg L et al (2006) Early treatment of acute stress disorder in children with major burn injury. Pediatr Crit Care Med 7(5): 498–499

    Article  Google Scholar 

  65. Deutsche Interdisziplinäre Vereinigung für Schmerztherapie, S3-Leitlinie “Behandlung akuter perioperativer und posttraumatischer Schmerzen”, Stand: 21. 05. 2007, inkl. Änderungen vom 20. 04. 2009

    Google Scholar 

  66. Cheung LH, Callaghan P, Chang AM (2003) A controlled trial of psycho-educational interventions preparing Chinese women for elective hysterectomy. Int J Stud 40(2): 207–216

    Google Scholar 

  67. Good M, Anderson GC, Stanton-Hicks M et al (2002) Relaxation and music reduce pain after gynecologic surgery. Pain Manag Nurs 3(2): 61–70

    Article  PubMed  Google Scholar 

  68. Good M, Anderson GC, Ahn S et al (2005) Relaxation and music reduce pain following intestinal surgery. Res Nurs Health 28(3): 240–251

    Article  PubMed  Google Scholar 

  69. Huth MM, Broome ME, Good M (2004) Imagery reduces children’s post-operative pain. Pain 110(1–2): 439–448

    Article  PubMed  Google Scholar 

  70. Nilsson U, Rawal N, Unestahl LE et al (2001) Improved recovery after music and therapeutic suggestions during general anaesthesia: a double-blind randomised controlled trial. Acta Anaesthesiol Scand 45(7): 812–817

    Article  PubMed  CAS  Google Scholar 

  71. Montgomery GH, David D, Winkel G et al (2002) The effectiveness of adjunctive hypnosis with surgical patients: a meta-analysis. Anesth Analg 94(6): 1639–45, table of contents

    PubMed  Google Scholar 

  72. Saadat H, Drummond-Lewis J, Maranets I et al (2006) Hypnosis reduces preoperative anxiety in adult patients. Anesth Analg 102(5): 1394–1396

    Article  PubMed  Google Scholar 

  73. Frenay MC, Faymonville ME, Devlieger S et al (2001) Psychological approaches during dressing changes of burned patients: a prospective randomised study comparing hypnosis against stress reducing strategy. Burns 27(8): 793–799

    Article  PubMed  CAS  Google Scholar 

  74. Bjordal JM, Johnson MI, Ljunggreen AE (2003) Transcutaneous electrical nerve stimulation (TENS) can reduce postoperative analgesic consumption. A meta-analysis with assessment of optimal treatment parameters for postoperative pain. Eur J Pain 7(2): 181–188

    Article  PubMed  Google Scholar 

  75. Richardson P, Mustard L (2009) The management of pain in the burns unit. Burns 35(7): 921–936

    Article  PubMed  CAS  Google Scholar 

  76. Gregoretti C, Decaroli D, Piacevoli Qu et al (2008) Analgosedation of patients with burns outside the operating room. Drugs 68(17): 2427–2443

    Article  PubMed  CAS  Google Scholar 

  77. Wilhelm W, Wrobel M, Kreuer S, Larsen R (2003) Remifentanil — Eine Bestandsaufnahme. Anaesthesist 52: 473–494

    PubMed  CAS  Google Scholar 

  78. Le Floch R, Naux E, Pilorget A, Arnould J-F (2006) Use of remifentanil for analgesia during dressing changes in spontaneously breathing non-intubated burn patients. Ann Burns Fire Disasters XIX (3)

    Google Scholar 

  79. Patterson DR, Ptacek JT, Carrougher GJ, Sharar SR (1997) Lorazepam as an adjunct to opioid analgesics in the treatment of burn pain. Pain 72(3): 367–374

    Article  PubMed  CAS  Google Scholar 

  80. Nilsson A, Steinvall I, Bak Z, Sjoberg F (2008) Patient controlled sedation using a standard protocol for dressing changes in burns: patients preference, procedural details and a preliminary safety evaluation. Burns 34: 929–934

    Article  PubMed  Google Scholar 

  81. MacPherson RD, Woods D, Penfold J (2008) Ketamine and midazolam delivered by patient-controlled analgesia in relieving pain associated with burns dressings. Clin J Pain 24(7)568–571

    Article  PubMed  Google Scholar 

  82. Gupta A, Bhandari PS, Shrivastava P (2007) A study of regional nerve blocks and local anesthetic creams (Prilox) for donor sites in burn patients. Burns 33: 87–91

    Article  PubMed  Google Scholar 

  83. Cuignet O, Pirson J, Boughrouph J, Duville D (2004) The efficacy of continuous fascia iliaca compartment block for pain management in burn patients undergoing skin grafting procedures. Anesth Analg 98: 1077–1081

    Article  PubMed  Google Scholar 

  84. Jellis WS, Gamelli RL, Furry PA et al (1999) Effect of topical local anesthetic application to skin harvest sites for pain management in burn patients undergoing skin-grafting procedures. Ann Surg 229(1): 115–120

    Article  Google Scholar 

  85. Pedersen JL, Callesen S, Møiniche S, Kehlet H (1996) Analgesic and anti-inflammatory effects of lignocaineprilocaine (EMLA) cream in human burn injury. Br J Anaesthesia 76: 806–810

    Article  CAS  Google Scholar 

  86. Raymond I, Nielsen TA, Lavigne G et al (2001) Quality of sleep and its daily relationship to pain intensity in hospitalized adult burn patients. Pain 92(3): 381–388

    Article  PubMed  CAS  Google Scholar 

  87. Schraag S, Checketts M et al (1999) Lack of rapid development of opioid tolerance during alfentanil and remifentanil infusions for postoperative pain. Anesth Analg 89: 753–757

    PubMed  CAS  Google Scholar 

  88. Luger TJ, Hayashi T, Grabner Weiss C, Hill H (1995) The spinal potentiating effect and the supraspinal inhibitory effect of midazolam on opioid-induced analgesia in rats. European J Pharmacol 275(2): 153–162

    Article  CAS  Google Scholar 

  89. Palaoglu O, Ayhan IH (1986) The possible role of benzodiazepine receptors in morphine analgesia. Pharmacol Biochem Behav 25: 15–217

    Article  Google Scholar 

  90. Perkins FM, Kehlet H (2000) Chronic pain as an outcome of surgery. Anesthesiology 93: 1123–1133

    Article  PubMed  CAS  Google Scholar 

  91. Kong R, Payen D (1994) Controlling sedation rather than sedation controlling you. Clin Intensive Care 5[5Suppl]:5–7

    PubMed  CAS  Google Scholar 

  92. Martin J, Bäsell K, Bürkle H et al (2005) Analgesie und Sedierung in der Intensivmedizin. S2-Leitlinien der deutschen Gesellschaft für Anästhesiologie und Intensivmedizin. Anaesthesiol Intensivmed 46 [Suppl] 1: 1–20

    Google Scholar 

  93. Ramsay MA, Savege TM, Simpson BR, Goodwin R (1974) Controlled sedation with alphaxalone-alphadolone. Br Med J 2(920): 656–659

    Article  PubMed  CAS  Google Scholar 

  94. Riker R, Picard F, Fraser G (1999) Prospective evaluation of the sedation-agitation-scale for adult critically ill patients. Crit Care Med 27(7): 1325–1329

    Article  PubMed  CAS  Google Scholar 

  95. Ely EW, Inouye SK, Bernard GR et al (2001) Delirium in mechanically ventilated patients: validity and reliability of the confusion assessment method for the intensive care unit (CAM-ICU). JAMA 286(21): 2703–2710

    Article  PubMed  CAS  Google Scholar 

  96. Ambuel B, Hamlett KW, Marx CM, Blumer JL (1992) Assessing distress in pediatric intensive care enviroments: the COMFORT scale. J Pediatr Psychol 17(1): 95–109

    Article  PubMed  CAS  Google Scholar 

  97. Weinert CR, Chlan L, Gross C (2001) Sedating critically ill patients: factors affecting nurses’delivery of sedative therapy. Am J Crit Care 10(3): 156–65; quiz 166-7

    PubMed  CAS  Google Scholar 

  98. Giessler GA, Mayer T, Trupkovic T (2009) Das Verbrennungstrauma. Anaesthesist 58: 474–484

    Article  PubMed  CAS  Google Scholar 

  99. Costa J, Cabre L, Molina R Carrasco G (1994) Cost of ICU sedation: comparison of empirical and controlled sedation methods. Clin Intensive Care 5 [5 Suppl.:17–21

    PubMed  CAS  Google Scholar 

  100. Frölich MA, Price DD, Robinson ME et al (2005) The effect of propofol on thermal pain perception. Anesth Analg 100: 481–486

    Article  PubMed  Google Scholar 

  101. Guignard B, Coste C, Costes H et al (2002) Supplementing Desflurane-Remifentanil anesthesia with smalldose ketamine reduces perioperative opioid analgesic requirements. Anesth Analg 95: 103–108

    Article  PubMed  CAS  Google Scholar 

  102. Edrich T, Friedrich AD, Eltzschig HK, Felbinger TW (2004) Ketamine for long-term sedation and analgesia of a burn patient. Anesth Analg 99: 893–895

    Article  PubMed  CAS  Google Scholar 

  103. Jung C, Granados M, Marsol P (2008) Use of sevoflurane sedation by the AnaConDa® device as an adjunct to extubation in a pediatric burn patient. Burns 34: 136–138

    Article  PubMed  CAS  Google Scholar 

  104. Whipple JK, Lewis KS, Quebbeman EJ et al (1995) Analysis of pain management in critically ill patients. Pharmacotherapy 15(5): 592–599

    PubMed  CAS  Google Scholar 

  105. Sim KM, Hwang NC, Chan YW, Seah CS (1996) Use of patient-controlled analgesia with alfentanil for burns dressing procedures: a preliminary report of five patients. Burns. 22(3): 238–241

    Article  PubMed  CAS  Google Scholar 

  106. Gallagher G, Rae CP, Kenny GN, Kinsella J (2000) The use of a target-controlled infusion of alfentanil to provide analgesia for burn dressing changes: A dose finding study. Anaesthesia 55(12): 1159–1163

    Article  PubMed  CAS  Google Scholar 

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Girtler, R., Gustorff, B. (2012). Pain management after burn trauma. In: Jeschke, M.G., Kamolz, LP., Sjöberg, F., Wolf, S.E. (eds) Handbook of Burns. Springer, Vienna. https://doi.org/10.1007/978-3-7091-0348-7_23

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