title: Prediction of effect-site concentration of sufentanil by dose-response target controlled infusion of sufentanil and propofol for analgesic and sedation maintenance in burn dressing changes.
abstract: This study was to investigate the feasibility and efficiency of by target-controlled infusion (TCI) for analgesia and sedation during burn dressing change, and to predict the effect-site concentration of sufentanil. Eighty burn patients were randomly and evenly divided into four groups according to target sufentanil effect-site concentration (0.2, 0.3, 0.4 and 0.5 ng/ml). The sufentanil-propofol TCI was carried out during dressing changes. The effect-site concentration of propofol was maintained at 1.2 μg/ml. The dose-response relationships of sufentanil for providing adequate analgesia were evaluated by visual analog scales and Ramsay sedation scores. The effect-site concentration of sufentanil was calculated by Probit regression analysis. Incidence of respiratory depression, doctors and patients' satisfaction and adverse events were assessed. The EC50 and EC95 of sufentanil to maintain anesthesia for uncovering the inner layer dressings during TCI were 0.278 ng/ml (95% CI 0.231-0.318 ng/ml) and 0.394 ng/ml (95% CI 0.366-0.530 ng/ml), respectively, while the EC50 and EC95 of sufentanil to maintain anesthesia for wound management were 0.349 ng/ml (95% CI 0.299-0.366 ng/ml) and 0.465 ng/ml (95% CI 0.430-0.563 ng/ml), respectively. Doctors and patients' satisfaction were significantly higher in the 0.4 and 0.5 ng/ml groups than the 0.2 ng/ml group. One and three patients had respiratory depression in the 0.4 and 0.5 ng/ml groups, respectively. No adverse events occurred after operations. In conclusion, low dose sufentanil-propofol TCI for anesthesia and sedation maintenance in burn dressing changes is feasible and effective, and wound management requires higher effect-site concentrations of sufentanil than disclosing inner layer dressings.
authors.affiliation: Department of Anesthesiology, Affiliated Taizhou Hospital of Wenzhou Medical College, Linhai, Zhejiang 317000, China.
authors.forename: Lingyang
authors.initials: L
authors.lastname: Chen
authors.affiliation: Department of Anesthesiology, Affiliated Taizhou Hospital of Wenzhou Medical College, Linhai, Zhejiang 317000, China. Electronic address: mingcang_wang@hotmail.com.
authors.forename: Mingcang
authors.initials: M
authors.lastname: Wang
authors.affiliation: Department of Anesthesiology, Affiliated Taizhou Hospital of Wenzhou Medical College, Linhai, Zhejiang 317000, China.
authors.forename: Haifei
authors.initials: H
authors.lastname: Xiang
authors.affiliation: Department of Anesthesiology, Affiliated Taizhou Hospital of Wenzhou Medical College, Linhai, Zhejiang 317000, China.
authors.forename: Xianju
authors.initials: X
authors.lastname: Lin
authors.affiliation: Department of Anesthesiology, Affiliated Taizhou Hospital of Wenzhou Medical College, Linhai, Zhejiang 317000, China.
authors.forename: Donghang
authors.initials: D
authors.lastname: Cao
authors.affiliation: Department of Burn, Affiliated Taizhou Hospital of Wenzhou Medical College, Linhai, Zhejiang 317000, China.
authors.forename: Liyue
authors.initials: L
authors.lastname: Ye
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D001458:Bandages; D002056:Burns / Q000628:therapy*; D004305:Dose-Response Relationship, Drug; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D007262:Infusions, Intravenous; D008297:Male; D010146:Pain / Q000188:drug therapy*; D010147:Pain Measurement; D015742:Propofol / Q000008:administration & dosage*; D017409:Sufentanil / Q000008:administration & dosage*
chemical_list: D000701:Analgesics, Opioid; D006993:Hypnotics and Sedatives; D017409:Sufentanil; D015742:Propofol
keywords: Burn; Dressing change; Effective concentration; Sufentanil; Target controlled infusion