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Related Experiment Videos

Patient-controlled sedation using propofol for dressing changes in burn patients: a dose-finding study.

Claudia Coimbra1, Manon Choinière, Thomas M Hemmerling

  • 1Department of *Anesthesiology and †Burn Centre, Hôtel-Dieu, Centre Hospitalier de l'Université de Montréal (CHUM), Université de Montréal, Québec, Canada.

Anesthesia and Analgesia
|August 23, 2003
PubMed
Summary

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Patient-controlled sedation (PCS) with propofol is safe and feasible for burn patients during painful dressing changes. Optimizing sedation involves titrating propofol doses and removing lockout intervals for better patient comfort.

Area of Science:

  • Anesthesiology
  • Burn Care
  • Sedation Management

Background:

  • First dressing changes after skin grafting in burn patients cause significant anxiety and pain.
  • Patient-controlled sedation (PCS) offers a potential solution for managing discomfort during these procedures.

Purpose of the Study:

  • To determine the feasibility and safety of PCS using propofol for burn patients undergoing their first dressing changes.
  • To evaluate different PCS setups for optimal sedation efficacy.

Main Methods:

  • A dose-finding study involving 20 burn patients familiarized with PCS.
  • Two groups: first 10 patients received fixed propofol bolus (0.3 mg/kg) with a 5-min lockout; second 10 received individualized, titrated bolus without lockout.
  • Sedation monitored using Bispectral Index (BIS), with pain intensity and satisfaction scores collected post-procedure.

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Main Results:

  • The initial fixed-bolus PCS setup resulted in insufficient sedation (BIS <80) despite stable vital signs.
  • The second group, with individualized titration and no lockout, achieved more effective sedation.
  • Both groups maintained safe respiratory and hemodynamic parameters.

Conclusions:

  • Patient-controlled sedation (PCS) with propofol is a feasible and safe option for burn patients during dressing changes.
  • Optimal sedation requires individualized propofol titration to achieve a target BIS or clinical sedation level.
  • Eliminating the lockout interval enhances the effectiveness of PCS in this patient population.