• Vladislav Shick, Evan E Lebovitz, and Emerson Conrad.
• University of Pittsburgh Medical Center Mercy Hospital, 1400 Locust St, Pittsburgh, PA 15219. Electronic address: shickv@upmc.edu.
• J Clin Anesth. 2017 Feb 1; 36: 62-66.

AbstractThe management of pain after burn injuries is a clinical challenge magnified in patients with significant comorbidities. Presently, burn pain is treated via a wide variety of modalities, including systemic pharmacotherapy and regional analgesia. Although the latter can provide effective pain control in patients with burn injuries, it is relatively underused. Furthermore, the development of ultrasound guidance has allowed for novel approaches and sparing of motor nerve blockade with preference toward sensory-specific analgesia that has not been possible previously. This can result in decreased opiate use and shorter latency to initiation of rehabilitation. In this report, we describe a patient with chronic pain, morbid obesity, and severe sleep apnea who presented with uncontrolled pain resulting from a burn injury to the dorsum of his feet. The treatment consisted of multimodal analgesia and placement of bilateral continuous superficial peroneal nerve catheters, as he underwent skin grafting and postprocedural hydrotherapy. This novel approach allowed for sparing of postprocedural opiates with positive clinical results.Copyright © 2016 Elsevier Inc. All rights reserved.

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