bandage-green

Burn Debridement and Escharotomy

Anesthesia Implications

Clinically reviewed by anesthesia providers · Updated

Position : Supine, Prone, Lateral, arms extended, Position changes between sittings with the surface being grafted; the thigh donor site must stay accessible.
Time : 2-4 hours (long)
Blood Loss : Very High (500+ ml)
Post-op Pain : Moderate (4-6)
Maintenance Paralytic : Yes
Blocks : Fascia Illiaca
Considerations : Arterial line, Central line, High Blood Loss, Tourniquet, Tumescent Solution

Anesthetic Approaches

1GETT, TIVA, Propofol Drip, Remifentanil Drip
2GETT, 1/2 MAC Gas, Remifentanil Drip
3MAC, Propofol Drip, Local Anesthetic
The Surgery

Timing - in a large burn, excision usually starts a few days after injury once fluid resuscitation is complete, then repeats every two to three days as the patient tolerates it. Early excision and...

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