Methoxyflurane analgesia for burns dressings.

THE terms 'burns dressing' and 'analgesia', as they are understood in the Mclndoe Burns Unit at East Grinstead, will first be defined. Methoxyflurane as an analgesic for burns dressings will then be discussed. The term 'burns dressing' may mean: (1) Debridement and cleansing of the burn wound on admission, together with intravenous cannulation and urethral catheterization. (2) Removal of old dressings and re-dressing of the burn wound. (3) Minor desloughing procedures. (4) Replacement of lyophilized skin by autograft. (5) Immersion of the patient in a saline bath, during which time he may receive physiotherapy. (6) In a small group of carefully selected patients, the taking of split thickness autograft. These procedures are all painful and require analgesia. This means the complete, consistent and subjective control of the patient's pain. Anything less than this produces a frightened and apprehensive patient who loses confidence in his doctors and nurses. This in turn retards the ultimate aim of the Unit-to reduce the emotional trauma ofthe patient's burn and to return an economically independent individual to the community. Any analgesic agent used for burns dressings must provide consistent, easily controlled levels of analgesia with no undue sedation. It should cause no cardiovascular or respiratory depression and no nausea or vomiting. It should not interfere with the patient's feeding pattern, since in the burnt patient, a feed missed is a feed lost. It should not interfere with the patient's emotional stability. In addition, if possible, repeated injections by the intravenous route should be avoided. In December 1968, as a result of a request by