Efficacy of dexmedetomidine versus midazolam when combined with butorphanol for sedation and analgesia during burn dressing changes: A randomized clinical trial

Abstract

Objective: The aim of this study was to compare dexmedetomidine-butorphanol (DB) and midazolam-butorphanol (MB) combinations for sedation, and analgesia in burn patients undergoing dressing changes.Methods: A total of 56 ASA I–II burn patients were included in this single-center randomized clinical trial. The ages of these patients were between 20 and 60 years. TBSA ranged from 10% to 50%. They were randomized to group DB and group MB during dressing change. In the DB group, each patient received a bolus dose of dexmedetomidine (0.5 μg kg−1) and intermittent boluses of butorphanol (20 μg kg−1). In the MB group, each patient received a bolus dose of midazolam (0.05 mg kg−1) and intermittent boluses of butorphanol (20 μg kg−1). The primary outcomes were sedation scores and pain scores. The second outcomes were vital signs, side effects, and butorphanol consumption.Results: The sedation scores of these two groups did not differ significantly (p > 0.05), and the pain scores of these groups were not significantly different (p > 0.05). More patients had hypotension in the DB group than in the MB group (6 versus 0, p = 0.01), but the number of patients who had respiratory depression was higher in the MB group compared with the DB group (4 versus 0, p = 0.038). Butorphanol consumption in the MB group was higher than in the DB group (p = 0.025).Conclusion: Dexmedetomidine is comparable to midazolam when combined with butorphanol in burn patients during dressing change. Compared with midazolam, it has the advantage of opioid-sparing effect.Clinical Trial Registration: [http://www.chictr.org.cn/showproj.aspx&proj=130622], identifier [ChiCTR2100049325].

Sub-hypnotic dose of midazolam is effective in reducing intraoperative nausea and vomiting during cesarean sections under spinal anesthesia

“…Mean ephedrine consumption in midazolam and placebo arms was also not significantly different. This result was similar to results obtained by Ding et al, 1 Ghasemloo et al 17 and Griffiths et al 2 No single antiemetic drug has the full ability to prevent N/V. Therefore, combinations of antiemetics have been used for the at-risk patient.…”

“…This result is similar to the study conducted by Ding et al, who mentioned that at all times, except the thirteenth minute, N/V were lower in the midazolam group and a statistical difference was seen between two categories. 1 Another recent study by Ghasemloo et al found results that were similar and concluded that a bolus dose of midazolam (2 mg) was more effective than metoclopramide (10 mg) for preventing N/V in parturient patients undergoing CS under SA. They found that the frequency of intraoperative nausea and vomiting was lower in the midazolam group compared with metoclopramide (15% vs. 52.5%).…”

“…In order to lower the complications of general anesthesia (GA) such as related to difficult intubation, gastric contents aspiration and increased maternal mortality in the pregnancy, spinal anesthesia (SA) is a widely used anesthetic technique for CS. 1,2 SA has a number of benefits, being dependable and simple to perform, being less expensive, offering the surgeon better operating conditions, restoring normal gastrointestinal function more quickly, preserving the patient's airway, reducing the risk of pulmonary complications, and having a lower incidence of deep venous thrombosis and pulmonary emboli development. 3 Ibrahem IG.…”

The median effective dose of propofol combined with butorphanol during artificial abortion: a randomized controlled trial

“…The most common related adverse reactions to butorphanol include nausea, vomiting, and dizziness, which are also dose-dependent ( 6 , 7 ). Butorphanol has recently been widely used in outpatient surgery due to its advantages of sedative and analgesic effects with a lower degree of respiratory depression ( 8 , 9 ).…”