Efficacy of Intravenous Patient-Controlled Analgesia (IV-PCA) using Fentanyl Compared with IV-PCA Using Morphine after Abdominal Surgery: A Prospective Randomized Study
Yukitoshi Niiyama*, Nobuyoshi Matsuoka, Reona Sugimoto and Michiaki Yamakage
Department of Anesthesiology, Sapporo Medical University School of Medicine, Hokkaido, Japan
- *Corresponding Author:
- Yukitoshi Niiyama
Department of Anesthesiology
Sapporo Medical University School of Medicine
South 1 West 16 Chuo-ku, Sapporo
Hokkaido 060-8556, Japan
Tel: +81-11-611-2111 ext: 3568
E-mail: [email protected]
Received Date: November 08, 2015; Accepted Date: January 27, 2016; Published Date: January 30, 2016
Citation: Niiyama Y, Matsuoka N, Sugimoto R, Yamakage M (2016) Efficacy of Intravenous Patient-Controlled Analgesia (IV-PCA) using Fentanyl Compared with IV-PCA Using Morphine after Abdominal Surgery: A Prospective Randomized Study. J Anesth Clin Res 7:598. doi: 10.4172/2155-6148.1000598
Copyright: © 2016 Niiyama Y, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Objective: To assess the efficacy and adverse effects of fentanyl intravenous (IV) patient-controlled analgesia (PCA) compared with morphine IV-PCA in patients after major abdominal surgery.
Methods: In a prospective, randomized, observer-blinded study, 40 patients with ASA physical status I-II who were scheduled to undergo major abdominal surgery. A standard general anesthetic was administered. Patients were randomly divided into two groups for 24h postoperatively: 1) Group F with fentanyl concentration of 25 μg/mL, background infusion of 25 μg/h, bolus of 25 μg, and lockout time of 10 min; and 2) Group M with morphine concentration of 1 μg/ml, no background infusion, bolus of 1 mg, and lockout time of 10 min. Numerical rating scale (NRS) pain scores at rest and on coughing and dose of additional PCA bolus and supplemental analgesic, and the incidence of adverse effects were assessed postoperatively during the first 24 h postoperatively.
Results: Compared to Group M, Group F showed significantly lower postoperative pain scores at rest throughout the observation period and on coughing at 2 h after the end of surgery. Incidence of nausea and median dose of antiemetic drugs were comparable between groups. No respiratory complications were encountered in this study. Patient satisfaction scores were significantly higher in Group F than in Group M.
Conclusions: Fentanyl IV-PCA provides more effective postoperative pain relief than morphine IV-PCA and greater patient satisfaction after abdominal surgery, without increasing the incidence of adverse effects.