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 μg/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' 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' 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.