The use of a target-controlled infusion of alfentanil to provide analgesia for burn dressing changes: A dose finding study

Abstract

Burn dressing changes require profound analgesia for a short duration. This study aimed to determine whether an operator-adjusted target-controlled infusion of alfentanil could provide effective analgesia for burn dressing changes. Ten patients with a burn of between 5 and 50% of body surface area were studied. Pain scoring was performed before, during and following the dressing change. Target and effect site concentrations of alfentanil were recorded during and for 15 min after the dressing change. Median baseline visual analogue pain score (VAS) was 22 mm. Median (range) duration of dressing change was 35 (20-75) min. Median (range) VAS during the dressing change was 30 (14-66) mm. All patients were satisfied with their pain relief. There was no respiratory depression or cardiovascular instability. No patient became sedated and there were no episodes of nausea or vomiting. Median (range) total dose of alfentanil was 2.6 (1-10.7) mg. This study supports the efficacy of an operator-adjusted target-controlled infusion of alfentanil to provide analgesia for burn dressing changes.