Intranasal Atomized Dexmedetomidine in Combination With Intranasal Atomized Butorphanol for Dressing Change Sedation and Analgesia in Adult Burn Patients: A Randomized Clinical Trial

We aimed to evaluate the efficacy of the intranasal atomized dexmedetomidine (IAD) + intranasal atomized butorphanol (IAB) combination therapy on adult patients with burns undergoing dressing changes. Herein, 46 adult patients with burns were enrolled and randomly divided into 2 groups: dexmedetomidine-butorphanol (DB) and saline-butorphanol, treated with atomized dexmedetomidine + butorphanol and saline + butorphanol, respectively. The primary outcomes were the Ramsay Sedation Scale (RSS) and the Visual Analog Scale (VAS) scores. The secondary outcomes were mean blood pressure (MBP), heart rate, respiratory rate (RR), peripheral blood oxygen saturation (SpO(2)), total butorphanol consumption, and adverse effects. The 2 groups were comparable in age, sex, weight, and total burn surface area. During dressing changes, the DB group exhibited significantly lower RSS levels (P < .05). Besides, the 2 groups showed no significant differences in VAS scores across all measurement time points. Notably, the DB group exhibited decreased MBP at the beginning of the operation (P < .0001), 10 min after (P < .0001), and 20 min after (P = .0205). Heart rate decreased significantly at the beginning (P = .0005) and 10 min after (P = .0088) in the DB group. Furthermore, the 2 groups showed no significant differences in RR and SpO(2) levels. In addition, the rescue butorphanol dose was lower in the DB group (P < .001). Finally, dizziness and nausea incidences were significantly lower in the DB group (P < .05). In conclusion, besides its hemodynamic adverse reactions, the IAD + IAB combination therapy exerted a better sedation effect in adult patients with burns than IAB treatment alone.