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熱傷患者の管理において,疼痛管理は創処置や外科的治療を円滑に進めるためだけでなく,患者との関係構築においても非常に重要である。いたずらに鎮痛をはかるのではなく,患者背景や疼痛の誘因を含めた評価を怠ってはならない。また,患者の苦痛や不安を取り除くことで,リハビリテーションを促進し生活の質(QOL)や日常生活動作(ADL)の向上につながることから,治療後の患者の社会生活への復帰まで見据えた疼痛管理が必要である。熱傷の重症度だけでなく,患者背景を考慮したうえでの薬物選択と安全な使用に努めることが求められる。熱傷の治療期間は長期化することも多く,創閉鎖後にも慢性的な疼痛や搔痒を訴える患者に対しては個別の対応が望ましい。
In the management of patients who suffered burn injuries, pain management is critical not only to facilitate wound care and surgical treatment but also to build rapport with the patient. Rather than attempting to achieve pain relief by simply treating the symptom, the patient's background and triggers for pain must be assessed. Pain management should also be conducted with an eye toward the patient's return to social life after treatment, as relieving the patient's pain and anxiety will promote rehabilitation and improve the quality of life and ability to perform activities of daily living. Efforts should be made to select medications and use them safely, taking into consideration not only the severity of the burn injury but also the patient's background. The treatment period for burns is often prolonged, and individualized treatment is desirable for patients who complain of chronic pain and itching even after wound closure.
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