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

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• 作者：Lingyang Chen^a ; Mingcang Wang^a ; ^{mingcang_wang@hotmail.com" class="auth_mail} ; Haifei Xiang^a ; Xianju Lin^a ; Donghang Cao^a ; Liyue Ye^b
• 关键词：Sufentanil ; Target controlled infusion ; Effective concentration ; Dressing change ; Burn
• 刊名：Burns
• 出版年：May, 2014
• 年：2014
• 卷：40
• 期：3
• 页码：455-459
• 全文大小：371 K

文摘

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 渭g/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鈥?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鈥?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.