Ding Xianchao, Luo Yi, Shi Lei, Liu Chang, Yan Zhixin
Department of Burn and Plastic Surgery, The Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu Province, PR China.
Department of Burn and Plastic Surgery, The Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu Province, PR China.
Burns. 2021 Nov;47(7):1594-1601. doi: 10.1016/j.burns.2020.12.025. Epub 2021 Jan 18.
This study aimed to compare the sedation and analgesic effects of butorphanol alone and butorphanol in combination with dexmedetomidine on dressing changes in adult burn patients.
From June 2016 to May 2019, 44 adult burn patients from our department were enrolled in this prospective, double-blinded study. Their total burn surface area (TBSA) varied from 10% to 30%; and the depth of burn injury ranged from second degree to third degree. The patients were randomized into two groups. In the control group, butorphanol combined with saline was injected into the body via venous route during dressing change. In the observation group, butorphanol in combination with dexmedetomidine was injected. The variation in mean blood pressure, heart rate, respiratory rate, and peripheral oxygen saturation were recorded at various time-points of the procedure. Visual Analogue Scale (VAS) of pain and Ramsay Sedation Scores (RSS) were also recorded at different time points. Consumption of butorphanol and adverse events in these two groups were compared.
The mean blood pressure and heart rate were significantly decreased in the observation group before butorphanol injection (P < 0.05) and before the dressing change (P < 0.05). The respiratory rates and peripheral oxygen saturation of these two groups showed no significant differences at all time points (P > 0.05). Patients in the observation group had lower VAS scores during dressing change (P < 0.05). The RSS Scores in the observation group were higher than those in the control group during (P < 0.05) and after the dressing change (P < 0.05). The consumption of butorphanol was more in the control group (P < 0.05), and the adverse events recorded in the control group were higher (P < 0.05).
Butorphanol combined with dexmedetomidine can reduce analgesic use of butorphanol during dressing change. This combination resulted in a higher sedation score and fewer adverse effects.
本研究旨在比较布托啡诺单独使用以及布托啡诺与右美托咪定联合使用对成年烧伤患者换药时的镇静和镇痛效果。
2016年6月至2019年5月，选取本科室44例成年烧伤患者纳入这项前瞻性双盲研究。他们的烧伤总面积（TBSA）为10%至30%；烧伤深度为二度至三度。患者被随机分为两组。对照组在换药时经静脉途径将布托啡诺与生理盐水注入体内。观察组则注入布托啡诺与右美托咪定的混合液。在操作的不同时间点记录平均血压、心率、呼吸频率和外周血氧饱和度的变化。在不同时间点还记录疼痛视觉模拟评分（VAS）和 Ramsay镇静评分（RSS）。比较两组布托啡诺的消耗量及不良事件。
观察组在注射布托啡诺前（P < 0.05）和换药前（P < 0.05）平均血压和心率显著降低。两组的呼吸频率和外周血氧饱和度在所有时间点均无显著差异（P > 0.05）。观察组患者在换药时VAS评分较低（P < 0.05）。观察组在换药期间（P < 0.05）和换药后（P < 0.05）的RSS评分高于对照组。对照组布托啡诺的消耗量更多（P < 0.05），且记录到的对照组不良事件更多（P < 0.05）。
布托啡诺与右美托咪定联合使用可减少换药时布托啡诺的镇痛用量。这种联合使用导致更高的镇静评分且不良反应更少。
