A Comparison Of Dezocine And Dexmedetomidine With Nsaids In Burn Wound Dressing Change Procedures: A Prospective, Double-Blind, Randomized Clinical Trial

Aim: To compare the analgesic effect of dezocine and dexmedetomidine with NSAIDs in burn wound dressing change procedures. Methods: A total of sixty adult burn patients from 2018/10/01 to 2019/04/30 in Shandong Provincial Hospital, China, were enrolled. At each dressing change procedure time, each patient randomly received one group of drugs from three dosage regimens: A (dezocine + dexmedetomidine); B (dezocine + placebo); C (flurbiprofen + placebo). Before the wound care procedure, the vital signs (BP, HR, SpO(2)), the Present Pain Index (PPI) (0-10), and the Willingness of Dressing Change (WDC) (-5-5) were recorded. During the process, HR, Other-evaluated Pain Index (OEPI) (0-4), and the procedure duration (min) were recorded. Afterwards, the BP, HR, SpO(2), VAS scores (0, 10, 30, 60, 120 min), and the side effects were recorded. Results: The background pain (PPI) was statistically undifferentiated among the groups. However, the patients' WDC was significantly higher in groups A (1.1) and B (1.3) compared to group C (-0.7). Moreover, during the procedures, the OEPI was significantly lower in groups A (1.6) and B (1.6) than in group C (2.0). As to the vital signs, the elevations of Bp (-9.4 +/- 1.1 mmHg, 6.9 +/- 1.0 mmHg and 14.3 +/- 2.2 mmHg) and HR (-0.3 +/- 1.2 bpm, 10.1 +/- 1.4 bpm and 7.6 +/- 2.4 bpm), as well as the decreases in SpO(2) (-0.2 +/- 0.2%, -0.8 +/- 0.2%, and -1.6 +/- 0.4%) were much smaller in group A. The VAS scores of the five time points afterwards showed a clear decreasing trend, but there were no significant inter-group differences. Inappetence (16.0%) was the most common undesirable symptom, which was undifferentiated between the groups, but somnolence was found to be significantly higher in group A (8.6%). Conclusion: Compared to flurbiprofen, dezocine reduced pain during the wound care procedures and improved the patients' willingness beforehand. Dexmedetomidine decreased the hemodynamic fluctuations but didn't show any adjuvant analgesic effect.