Department of Palliative Medicine, Poznan University of Medical Sciences, Poznan, Poland.
Department of Forensic Medicine, Wroclaw Medical University, Wroclaw, Poland.
Burns. 2021 Jun;47(4):880-887. doi: 10.1016/j.burns.2020.10.006. Epub 2020 Oct 16.
The aim of this study was to assess the analgesic efficacy of sufentanil in dressings after surgical treatment of burn wounds.
Twenty adult patients, who underwent surgical treatment of third-degree burn wounds under general anesthesia, were included. Two of the patients underwent surgery twice. During surgery, patients received 50-100 μg fentanyl every 20-30 min and, after surgery, patients received 100 mg ketoprofen twice daily. Additionally, ten patients (group 1) received 50 μg sufentanil added to the burn wound dressings soaked in octenidine and phenoxyethanol while 10 patients (group 2) received 25 μg sufentanil added to the same dressings. The rescue analgesic, which was administered when pain intensified, was 5 mg subcutaneous morphine. Plasma sufentanil concentrations were assayed at 1, 2, 3, and 6 h after surgery completion and when pain was reported, along with pain intensity evaluation.
Sufentanil was not detected in the serum of any patients. Rescue morphine was given during the postoperative period (24 h) in one patient in group 1 (who underwent surgery twice) and three patients in group 2. The mean sufentanil concentration in dressings was higher in group 1 (0.13 ± 0.03) than group 2 (0.06 ± 0.03 μg/mL; p < 0.001). The group 1 patient who received rescue morphine had a sufentanil concentration of 0.10 μg/mL, which was the lowest concentration in group 1. Group 2 patients who received rescue morphine had sufentanil concentrations of at least two-fold lower (0.03-0.05 μg/mL). No adverse effects were observed.
Sufentanil in dressings after burn wound surgery provides effective and safe analgesia and the sufentanil concentration in dressings should be ≥0.10 μg/mL in a solution of octenidine and phenoxyethanol.
本研究旨在评估舒芬太尼在烧伤创面手术后敷料中的镇痛效果。
共纳入 20 例接受全身麻醉下三度烧伤创面手术的成年患者。其中 2 例患者接受了两次手术。手术期间，患者每 20-30 分钟接受 50-100μg 芬太尼，手术后每天接受 100mg 酮洛芬两次。此外，10 例患者（第 1 组）接受 50μg 舒芬太尼加入奥替尼啶和苯氧乙醇浸湿的烧伤创面敷料，而 10 例患者（第 2 组）接受相同敷料中加入 25μg 舒芬太尼。当疼痛加剧时，给予 5mg 皮下吗啡作为解救镇痛剂。术后 1、2、3 和 6 小时及报告疼痛时测定血浆舒芬太尼浓度，并评估疼痛强度。
未在任何患者的血清中检测到舒芬太尼。第 1 组中有 1 例（接受了两次手术）和第 2 组中有 3 例患者在术后期间（24 小时）给予了吗啡解救。第 1 组（0.13±0.03）的舒芬太尼在敷料中的平均浓度高于第 2 组（0.06±0.03μg/mL；p<0.001）。接受吗啡解救的第 1 组患者的舒芬太尼浓度为 0.10μg/mL，这是第 1 组中的最低浓度。接受吗啡解救的第 2 组患者的舒芬太尼浓度至少低两倍（0.03-0.05μg/mL）。未观察到不良反应。
在烧伤创面手术后使用舒芬太尼敷料可提供有效且安全的镇痛效果，奥替尼啶和苯氧乙醇溶液中的舒芬太尼浓度应≥0.10μg/mL。
