Questions: Which type of pharmacologic intervention would be most appropriate for a patient with extensive burns on all four extremities? Patient-controlled analgesia (PCA) Peripheral nerve catheter Epidural analgesia Topical analgesia

The answer is the first one: Patient-controlled analgesia (PCA).

Explanation for each option:

1. Patient-controlled analgesia (PCA): This method allows the patient to self-administer a controlled amount of pain medication, typically opioids, through an intravenous line. It is particularly useful for managing severe pain, such as that experienced by patients with extensive burns. PCA provides the flexibility for the patient to manage their pain effectively, which is crucial in burn cases where pain levels can fluctuate.

2. Peripheral nerve catheter: This involves the continuous infusion of local anesthetics near a specific nerve or group of nerves to block pain in a targeted area. While effective for localized pain, it may not be suitable for extensive burns covering all four extremities, as it would require multiple catheters and might not provide comprehensive pain relief.

3. Epidural analgesia: This method involves the injection of pain medication into the epidural space of the spinal cord. It is effective for certain types of pain, such as postoperative pain or labor pain, but may not be the best choice for extensive burn pain management, as it primarily affects the lower body and may not provide adequate relief for burns on all extremities.

4. Topical analgesia: This involves applying pain-relieving medication directly to the skin. While it can be useful for minor burns or localized pain, it is generally insufficient for managing the severe and widespread pain associated with extensive burns.

In summary, patient-controlled analgesia (PCA) is the most appropriate choice for managing the severe and widespread pain associated with extensive burns on all four extremities, as it allows for effective and flexible pain management.