Email Alerts
RSS
Volume 39 Issue 11
Nov.  2023
Turn off MathJax
Article Contents
Article Navigation >  CHINESE JOURNAL OF BURNS AND WOUNDS  > 2023  >  39(11): 1014-1020
Zhang MS,Huang L,Zhu H,et al.Prospective randomized controlled trial on the application of sevoflurane inhalation sedation and analgesia during dressing changes in children with extensive burns[J].Chin J Burns Wounds,2023,39(11):1014-1020.DOI: 10.3760/cma.j.cn501225-20230731-00027.
Citation: Zhang MS,Huang L,Zhu H,et al.Prospective randomized controlled trial on the application of sevoflurane inhalation sedation and analgesia during dressing changes in children with extensive burns[J].Chin J Burns Wounds,2023,39(11):1014-1020.DOI: 10.3760/cma.j.cn501225-20230731-00027.
shu

Prospective randomized controlled trial on the application of sevoflurane inhalation sedation and analgesia during dressing changes in children with extensive burns

doi: 10.3760/cma.j.cn501225-20230731-00027
  • 1.

    Department of Burns and Plastic Surgery, Kunming Children's Hospital, Kunming 650031, China

  • 2.

    Sedative and Analgesic Center, Kunming Children's Hospital, Kunming 650031, China

Funds:

Health Research Fund of Kunming Municipal Health Commission 2022-04-03-001

More Information
  • Corresponding author: Fu Jinfeng, Email: fujinfeng@etyy.cn
  • Received Date: 2023-07-31
    Abstract
  •   Objective   To explore the safety and effectiveness of the application of sevoflurane inhalation sedation and analgesia during dressing changes in children with extensive burns.   Methods   A prospective randomized controlled research was conducted. From March 2020 to January 2023, 216 children with extensive burns who met the inclusion criteria were admitted to the Department of Burns and Plastic Surgery of Kunming Children's Hospital. According to the random number table, the children were divided into sevoflurane group and ibuprofen group, with 103 cases left in sevoflurane group (67 males and 36 females, aged 1 (1, 2) years), and 98 cases left in ibuprofen group (67 males and 31 females, aged 1 (1, 2) years) after the exclusion of several dropped-out children. Children in sevoflurane group received sevoflurane inhalation for sedation and analgesia during dressing changes, while those in ibuprofen group took oral ibuprofen for analgesia before dressing changes. The heart rate, mean arterial pressure (MAP), and percutaneous arterial oxygen saturation (SpO 2) of the children were monitored and recorded at 30 minutes before the start of dressing changes, immediately after debridement, and at 30 minutes after the completion of dressing changes. The face, legs, activity, cry, and consolability scale and Ramsay sedation scale were used to evaluate the pain intensity and degree of sedation, respectively, at 30 minutes before the start of dressing changes, immediately after debridement, and at 30 minutes after the completion of dressing changes. The duration of dressing changes and the total number of dressing changes during hospitalization were recorded. The Houston Pain Outcome Instrument questionnaire was used to assess the satisfaction of the dressing-changing surgeons and a family member of the child with the analgesic effects during the process of dressing change when the children were discharged from the hospital. The occurrence of adverse reactions such as respiratory depression and hypoxemia that occurred during the process of dressing change were monitored and recorded. Data were statistically analyzed with independent sample t test, analysis of variance for repeated measurement, Wilcoxon rank-sum test, chi-square test, and Fisher's exact probability test.   Results   At 30 minutes before the start of dressing changes and 30 minutes after the completion of dressing changes, there were no statistically significant differences in heart rate, MAP, and SpO 2 between children in the two groups ( P>0.05). Immediately after debridement, compared with those in ibuprofen group, the heart rate and MAP of children in sevoflurane group were significantly decreased (with t values of 8.10 and 4.37, respectively, P<0.05), while the SpO 2 was significantly increased ( t=21.77, P<0.05). At 30 minutes before the start of dressing changes and 30 minutes after the completion of dressing changes, there were no statistically significant differences in the score of pain intensity and score of sedation degree between children in the two groups ( P>0.05). Immediately after debridement, compared with that in ibuprofen group, the score of pain intensity of children in sevoflurane group was significantly decreased, while the score of sedation degree was significantly increased (with t values of 42.87 and 72.45, respectively, P<0.05). The duration of dressing changes and the total number of dressing changes during hospitalization of patients in sevoflurane group were (18±3) min and (4.1±1.0) times, respectively, which were both significantly shorter than (26±7) min and less than (6.6±1.4) times in ibuprofen group, respectively (with t values of -4.44 and 14.17, respectively, P<0.05). Upon discharge, the satisfaction scores of dressing-changing surgeons and the family members of children with the analgesic effects during the process of dressing change in sevoflurane group were significantly higher than those in ibuprofen group (with t values of 44.23 and 36.55, respectively, P<0.05). There were no statistically significant differences in the incidence of respiratory depression, hypoxemia, hypotension, coughing, nausea, and vomiting during the process of dressing change between children in the two groups ( P>0.05).   Conclusions   Application of sevoflurane inhalation during dressing changes in children with extensive burns can safely and effectively control pain and sedation, shorten the time for dressing change, with fewer adverse reactions. This method can be used for routine dressing change in pediatric burn wards.

     

    • FullText(HTML)
  • loading
    • References(19)
  • [1]
    张成,彭源,罗小强,等.3 067例住院烧伤患儿流行病学调查及其感染的病原学特征分析[J].中华烧伤杂志,2021,37(6):538-545.DOI: 10.3760/cma.j.cn501120-20210201-00044.
    [2]
    吴巍巍,路英慧,程丹,等.烧伤患儿的疼痛评估及非药物干预研究进展[J].中华烧伤杂志,2020,36(1):76-80.DOI: 10.3760/cma.j.issn.1009-2587.2020.01.015.
    [3]
    方艳丽,赵敏,潘桂芹.七氟醚潮气量法吸入用于小儿全身麻醉诱导的效果观察[J].中国实用医刊,2021,48(14):53-56.DOI: 10.3760/cma.j.cn115689-20210331-01230.
    [4]
    冯华丽,王莎,项芹,等.烧伤患儿创面换药时中深度镇静的研究进展[J].中华烧伤与创面修复杂志,2023,39(1):96-100.DOI: 10.3760/cma.j.cn501225-20220421-00153.
    [5]
    De Sanctis BriggsV. Magnetic resonance imaging under sedation in newborns and infants: a study of 640 cases using sevoflurane[J]. Paediatr Anaesth, 2005, 15(1): 9-15.DOI: 10.1111/j.1460-9592.2005.01360.x.
    [6]
    中华医学会儿科学分会急救学组,中华医学会急诊医学分会儿科学组,中国医师协会儿童重症医师分会.中国儿童重症监护病房镇痛和镇静治疗专家共识(2018版)[J].中华儿科杂志,2019,57(5):324-330.DOI: 10.3760/cma.j.issn.0578-1310.2019.05.002.
    [7]
    何冠凤,何珊,左泽兰.重症监护室儿童镇静评估的研究进展[J].中国小儿急救医学,2022,29(1):60-64.DOI: 10.3760/cma.j.issn.1673-4912.2022.01.012.
    [8]
    黄志华,邵海军,陶国荣,等.舒芬太尼联合地佐辛应用于胰腺肿瘤手术后患者自控静脉镇痛的效果评价[J].上海医学,2023,46(5):291-296.DOI: 10.19842/j.cnki.issn.0253-9934.2023.05.007.
    [9]
    黄娅娟,高国燕,刘训华,等.丙泊酚复合瑞芬太尼自控镇静镇痛在烧伤换药中的应用观察[J].中华烧伤杂志,2014,30(6):525-529.DOI: 10.3760/cma.j.issn.1009-2587.2014.06.014.
    [10]
    AnwarK.Pathophysiology of pain[J].Dis Mon,2016,62(9):324-329.DOI: 10.1016/j.disamonth.2016.05.015.
    [11]
    吴巍巍,刘淑梅,贺婷婷,等.虚拟现实技术在烧伤疼痛干预中的研究进展[J].中华烧伤杂志,2020,36(7):620-622.DOI: 10.3760/cma.j.cn501120-20190402-00159.
    [12]
    ISBI Practice Guidelines Committee, SubcommitteeAdvisory, SubcommitteeSteering. ISBI practice guidelines for burn care, part 2[J]. Burns, 2018, 44(7): 1617-1706. DOI: 10.1016/j.burns.2018.09.012.
    [13]
    刘配配,郑吉建,白洁,等.采用灌注指数监测小儿全身麻醉期间伤害性刺激反应的临床观察[J].上海交通大学学报(医学版),2018,38(1):67-70.DOI: 10.3969/j.issn.1674-8115.2018.01.012.
    [14]
    方静.七氟烷在新生儿麻醉诱导和中深度镇静中应用研究进展[J].现代医药卫生,2022,38(20):3512-3516.DOI: 10.3969/j.issn.1009-5519.2022.20.021.
    [15]
    张广源, 索生红, 杨森林.布洛芬用于儿童和青少年骨折镇痛的效果和安全性:系统评价和Meta分析[J].国际麻醉学与复苏杂志, 2018,39(7): 650-657.DOI: 10.3760/cma.j.issn.1673-4378.2018.07.009.
    [16]
    ShuklaA,ChowdharyV.Neurodevelopmental outcome at 5 years of age after general anaesthesia or awake-regional anaesthesia in infancy (GAS): an international, multicentre, randomised, controlled equivalence trial[J].Acta Paediatr,2019,108(11):2115-2116.DOI: 10.1111/apa.14943.
    [17]
    WarnerDO, ZaccarielloMJ, KatusicSK, et al. Neuropsychological and behavioral outcomes after exposure of young children to procedures requiring general anesthesia: the Mayo Anesthesia Safety in Kids (MASK) study[J]. Anesthesiology, 2018, 129(1): 89-105. DOI: 10.1097/ALN.0000000000002232.
    [18]
    MillerTL, ParkR, SunLS. Report on the Fifth PANDA Symposium on "Anesthesia and Neurodevelopment in Children"[J]. J Neurosurg Anesthesiol, 2016, 28(4): 350-355. DOI: 10.1097/ANA.0000000000000346.
    [19]
    强婷婷,张丽,胡宪文.七氟醚对发育期大脑认知功能的影响及其机制研究进展[J].国际麻醉学与复苏杂志,2022,43(6):664-668.DOI: 10.3760/cma.j.cn321761-20210531-00577.
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(1)  / Tables(5)

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (498) PDF downloads(24) Cited by()
    Proportional views
    Related

    Copyright © Chinese Journal of Burns京ICP备07035254号-14

    E-mail：shaoshangzazhi@163.com

    Website：https://zhsszz.xml-journal.net/

    Supported by: Beijing Renhe Information Technology Co. Ltd    

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return