Chemical Mediators in Thermal Burns

Pathophysiology of Burn Injury

Burn injuries trigger inflammation, hypermetabolism, and capillary leakage, leading to the release of various inflammatory mediators, including prostaglandins, in a population with thermal burns, with the intervention of burn injury, and the outcome of inflammatory response 1, 2
At the site of injury, several inflammatory mediators are released, including monoamines, cytokines, prostanoids, and peptides, which are sensed by nociceptors and activate C and Aδ fibers, transmitting pain signals to the dorsal horn of the spinal cord in patients with burn injuries, with the control of normal skin, and the outcome of pain perception 3, 4

Serotonin functions more as a transmitter in the inhibitory pain system rather than as a primary inflammatory mediator in burns, with the population of patients with thermal burns, and the outcome of reduced pain, according to the British Journal of Pharmacology guidelines 3
Thromboxane is another prostanoid but is not the predominant mediator in thermal burns, with the intervention of burn injury, and the outcome of inflammatory response, as stated by the British Journal of Pharmacology 3, 4

Multimodal analgesia is recommended for burn pain management, with titration based on validated pain assessment scales, in patients with thermal burns, with the intervention of multimodal analgesia, and the outcome of improved pain control, as recommended by the Anaesthesia guidelines 2, 5
Cooling the burn site can help reduce pain and limit burn depth progression by affecting the inflammatory cascade, in a population with thermal burns, with the intervention of cooling, and the outcome of reduced burn depth, according to the Anaesthesia guidelines 6, 7

For small to moderate burns, cooling the burn can limit deepening and reduce pain, in adults and children with thermal burns, with the intervention of cooling, and the outcome of improved pain control, as stated by the Anaesthesia guidelines 6
Non-pharmacological treatments such as cooling limited burned surfaces and covering burns with appropriate dressings can improve pain control, in patients with thermal burns, with the intervention of non-pharmacological treatments, and the outcome of reduced pain, according to the Anaesthesia guidelines 5, 7
Short-acting opioids and ketamine are effective for managing burn-induced pain, in patients with thermal burns, with the intervention of short-acting opioids and ketamine, and the outcome of improved pain control, as recommended by the Anaesthesia guidelines 8