OBJECTIVE: A variety of agents and techniques are employed in different 
countries, settings, and medical specialities in order to provide analgesia and 
sedation in intensive care. Several national guidelines have been published in 
recent years regarding sedation and analgesia in a general intensive care 
patient population; however, to date no data exist for patients with burn 
injuries. The aim of the study was to evaluate analgesia and sedation practice 
in the intensive care of burn patients in Europe.
DESIGN: A postal survey was sent to 188 burn centers in Europe. The addresses 
were provided by the European Burn Association. The heads of the intensive care 
units were asked to fill in a structured questionnaire concerning the use of 
analgesia and sedation in their units.
RESULTS: The overall response rate was 27.04%; 63% of European burn centers 
reported standard operating procedures for sedation and analgesia. A regular 
score-based assessment of sedation, analgesia, and delirium is carried out by 
58%, 60%, and 5%, respectively, of the units. Propofol is the sedative most 
frequently used for short-term sedation and the weaning phase, whereas 
benzodiazepines are the preferred substances for medium- and long-term sedation. 
α2-agonists are widely used during weaning. Opioids are the analgesics of choice 
for approximately two thirds of the patients. Ketamine is preferred for 
analgesia in 12% and for sedation in 13% of all substances used. For painful 
procedures (eg, dressing changes), a large variety of different combinations of 
analgesics and sedatives are used. Half of the responding intensive care units 
use neuromuscular blocking agents and supportive nonpharmacological techniques. 
Two thirds of the European burn centers perceive the need for change in their 
concepts of analgesia and sedation.
CONCLUSION: A wide variety of drugs are used for analgesia and sedation in 
European burn centers. This would appear to be due to lack of guidelines or 
scientific evidence. The implementation of regular assessment of sedation, 
analgesia, and delirium must be improved. The widespread use of neuromuscular 
blocking agents should be restricted or even abandoned. Two thirds of the units 
identify a need for change in their concepts. Valid scientific data are needed 
to develop guidelines for sedation and analgesia of burn patients.