Improvement of dexmedetomidine to postoperative intravenous analgesia by fentanyl in patients with large-area burn

Objective To evaluate the efficacy and safety of dexmedetomidine (Dex) used for postoperative intravenous analgesia in patients with large-area burn.Methods Forty 18-60 years old patients,undergoing escharectomy were randomly assigned into two groups with 20 cases each.Group Ⅰ received patient-controlled intravenous analgesia(PCIA) with fenmnyl,Group Ⅱ received PCIA with Dex and fentanyl.Visual analogue scales (VAS) scores and Ramsay scores at 4,8,24 h and 48 h after operation and the incidence of nausea and vomit,somnolence,bradycardia and respiratory depression were recorded.The satisfactory degree of patients was recorded at 48 h.Results Compared with Group Ⅰ,the VAS score of Group Ⅱ at any time point and the incidence of nausea and vomit in Group Ⅱ were significantly decreased.There was no significant difference in the incidence of somnolence,bradycardia,respiratory depression and Ramsay score between the two groups.The satisfactory degree of patients in Group Ⅱ (95％) was obviously higher than that in Group Ⅰ (65％,P＜0.05) at 48 h.Conclusions The application of Dex coupled with fentanyl in PCIA can result in satisfactory effect of analgesia and sedation and decrease the incidence of nausea and vomit significantly,which will do more good to the patients with large-area burn. Key words: Burn;  Postoperative intravenous analgesia;  Dexmedetomidine;  Fentanyl