LOCOREGIONAL ANESTHESIA FOR POSTOPERATIVE PAIN MANAGEMENT IN BURN PATIENTS UNDERGOING ESCHARECTOMY AND AUTOLOGOUS SKIN GRAFT SURGERY

V. Fabbricatore¹, V. Pota², F. Coppolino², F. Coletta³, A. Tomasello³, P. Sansone², M. Fiore², M.B. Passavanti², R. Villani³, M.C. Pace² | ¹Residency Program in Anesthesiology, Resuscitation, Intensive and Pain Therapy University of Campania "Luigi Vanvitelli", Napoli; ²Department of Women, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Napoli; ³Emergency Anesthesia, Burn Intensive Care Unit and Poison Control, AORN Antonio Cardarelli Hospital, Naples, Italy

INTRODUCTION
Pain control in burn patients undergoing escharectomy and skin grafting remains a critical challenge. Opioids, while effective, can lead to tolerance, dependence, and prolonged recovery. Locoregional anesthesia offers an alternative strategy, potentially reducing opioid use and improving patient outcomes.
METHODS
This single-center retrospective study included 25 adult patients with deep leg burns requiring escharectomy and autologous skin grafting. All patients received ultrasound-guided sciatic popliteal and adductor canal nerve blocks with ropivacaine and clonidine. The same protocol was used for the donor site on the contralateral leg. Pain intensity was assessed using the Numerical Rating Scale (NRS). Postoperative opioid consumption (morphine equivalents) and 30-day readmission rates were recorded. Data were analyzed using descriptive statistics.
RESULTS
Postoperative pain control was satisfactory in most cases. Eight patients (32%) reported no pain (NRS 0), 13 (52%) had mild pain (NRS 1–3), and 4 (16%) had moderate pain (NRS 4–6). No patients reported severe pain (NRS 7–10). Only four patients (16%) required rescue opioid doses. No readmissions were recorded within 30 days of discharge. No adverse effects related to the blocks were observed.
CONCLUSIONS
Locoregional anesthesia with peripheral nerve blocks appears to be a safe and effective method for postoperative pain management in burn patients undergoing escharectomy and skin grafting. This approach reduced opioid consumption and prevented hospital readmission, supporting its role in multimodal analgesia for this population.