Annals of Medicine and Surgery 83(2022)104756Contents lists available at ScienceDirectAnnals of Medicine and SurgeryELSEVIERjournal homepage:www.elsevier.com/locate/amsuReviewEvidence-based practical guideline for procedural pain management andsedation for burn pediatrics patients undergoing wound care proceduresAdanech Shiferaw,Simeneh Mola,Amanu Gashaw,Ashagrie SintayehuDilla University,College of Medicine and Healt Sclence,Dilla,EthlopiaHawassa Universiry,College of Medicine and Health Sclence,Howassa,EthiopiaWolay Sodo Universiry,College of Medicine and Health Sclence,Wolai Sodo,EthiopiaARTICLE INFOABSTRACTKeywordsBackground:Almost all children with burns experience pain as a result of a complex pathophysiologic processPain managementthat is usually untreated,and up to 38%of all pediatric burn victims develop anxiety disorders due to pain afterSedationhospital admission.Hence,it is important to manage pain and anxiety in the care of burn victim children.TheBurngoal of this review was to develop an evidence-based guideline for procedural pain management and sedation forWound carePediatricsburned children undergoing wound care procedures.Methodology:The review was reported according to Reporting Items for practice Guidelines in Healthcare(RIGHT)protocol.A search of literature was done from Cochrane review,PubMed,Google Scholar,Embase,webof science and Hinari database key words "pediatrics","children","burn","procedural wound care","wounddressing","non-pharmacological","analgesia","pain management"and "sedation"were used.Extraction andfiltering of the results was determined based on the interventions,outcome,population,and methodologicalquality,and incusion and exclusion criteria.Finally,6 systematic review and meta-analysis,lobservationalstudy,and 16 randomized control trial Studies were appraised for quality,and conclusion was made based ontheir level of evidence and grade of recommendation.Conclusion and recommendation:For effective management of procedural pain and accompanying anxiety duringWCP in children,we recommend using non-pharmacological strategies as an adjunct with calculated dose ofanalgesics based on the children's analgesic requirements.We also recommend ketamine-dexmedetomidine as aneffective first-line analgesic-sedation,and ketamine-propofol,propofol-remifentanil,propofol-fentanyl,andketamine-midazolam as useful sedative-analgesic options.1.Backgroundpost-traumatic stress disorder (PTSD)symptoms [3].Therefore adequate and satisfying painmanagement is crucial for theBum injuries are among the top five most common causes of non-pediatric population undergoing wound care procedures.However,thefatal pediatric injuries on the globe and the sixth greatest cause ofstandard analgesia used within pediatric burn settings was inadequate inmortality among 5-14 year old children in low and middle-incomefulfilling children's need and decreasing pain-related anxiety andcountries [1].distress.Study shows initial sedative strategies failed to
