Use of remifentanil for analgesia during dressing change in spontaneously breathing non-intubated burn patients

We report our experience in using remifentanil as sole agent for the analgesia of spontaneously breathing non-intubated burn patients during dressing changes. Sixty procedures were collected and analysed. Remifentanil was used during monitoring of vital functions, with oxygen inhalation throughout the procedure, at the bedside in the intensive care unit ward. Infusion speed was varied by the nurse in charge, depending on pain, analgesia, and adverse effects. The dosage of continuous infusion ranged from 0.125 to 1 mg.kg-1.mn-1 (average, 0.42). All patients received intravenously morphine 30 min before the end of the procedure (average, 10 mg). The main side effects were hypoxia and drowsiness, always quickly reversed when the doses were reduced. All patients had low levels of pain during and after the procedure, and were satisfied with the analgesia protocol. We conclude that remifentanil is another possible manner of analgesia in the dressing of burn patients, but that it must be used in an "anaesthesiological" environment.