Comparison of Remifentanil and Fentanyl for Postoperative Pain Control after Abdominal Hysterectomy.
10.3349/ymj.2008.49.2.204
- Author:
Seung Ho CHOI
1
;
Bon Nyeo KOO
;
Soon Ho NAM
;
Sung Jin LEE
;
Ki Jun KIM
;
Hae Keum KIL
;
Ki Young LEE
;
Dong Hyuk JEON
Author Information
1. Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea. koobn@yuhs.ac
- Publication Type:Original Article ; Comparative Study ; Randomized Controlled Trial
- Keywords:
Postoperative nausea and vomiting;
postoperative pain control;
remifentanil;
respiratory depression
- MeSH:
Adolescent;
Adult;
Aged;
Analgesics, Opioid/administration & dosage/therapeutic use;
Drug Administration Schedule;
Female;
Fentanyl/administration & dosage/*therapeutic use;
Humans;
Hysterectomy/*adverse effects;
Infusions, Intravenous;
Middle Aged;
Pain, Postoperative/*drug therapy/etiology;
Piperidines/administration & dosage/*therapeutic use;
Treatment Outcome
- From:Yonsei Medical Journal
2008;49(2):204-210
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: In this randomized, double-blind study, we investigated the analgesic efficacy and side effects of continuous constant-dose infusions of remifentanil after total abdominal hysterectomy and compared it to fentanyl. MATERIALS AND METHODS: Fifty-six adult female patients scheduled for elective total abdominal hysterectomy were enrolled in this study. Patients were randomly assigned to two groups according to fentanyl (group F, n=28) or remifentanil (group R, n=28) for postoperative analgesia. Patients in group F were given fentanyl intravenously with an infusion rate of fentanyl 0.5 microgram/kg/hr; group R was given remifentanil with an infusion rate of remifentanil 0.05 microgram/kg/min for 2 days. Pain intensity at rest, occurrence of postoperative nausea and vomiting (PONV), dizziness, pruritus, and respiratory depression were assessed 1 hr after arrival at the post-anesthesia care unit, at 6; 12; 24; and 48 hr post-operation and 6 hr post-infusion of the study drug. Pain was evaluated by using visual analogue scale (VAS; 0-10). The time that patients first requested analgesics was recorded as well as additional analgesics and antiemetics. RESULTS: There were no significant differences in VAS, time to first postoperative analgesics, and additional analgesics between the 2 groups. The incidences and severities of PONV and opioid related side effects were not different between the groups; however, there were 3 episodes (10.7%) of serious respiratory depression in group R. CONCLUSION: Continuous infusion technique of remifentanil did not reveal any benefits compared to fentanyl. Furthermore, it is not safe for postoperative analgesia in the general ward.
