Potential analgesia of lumbar intrathecal fentanyl in breast cancer surgery

Background Various regional anesthetic techniques are used during mastectomy for reduction of pain and side effects. The intrathecal (IT) route for drug administration is interesting despite the poorly understood and complex nature of cerebrospinal fluid kinetics and IT drug pharmacokinetics. Lumbar...

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Bibliographic Details
Published in:Research and Opinion in Anesthesia & Intensive Care 2018-07, Vol.5 (3), p.220-225
Main Authors: Mazy, Alaa Abdou, Saber, Hossam El-Said
Format: Article
Language:English
Subjects:
Analgesia
Anesthesia
Atracurium
Breast cancer
Bupivacaine
Central nervous system agents
Drug dosages
Fentanyl
Heart surgery
Medical research
Narcotics
Opioids
Ostomy
Pain
Pain management
Patients
Pruritus
Stress response
Sufentanil
Surgery
Tromethamine
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Summary:Background Various regional anesthetic techniques are used during mastectomy for reduction of pain and side effects. The intrathecal (IT) route for drug administration is interesting despite the poorly understood and complex nature of cerebrospinal fluid kinetics and IT drug pharmacokinetics. Lumbar IT opioids are used for analgesia during thoracic and cardiac surgeries, but not for breast surgeries. IT fentanyl (F) is evaluated in this study for mastectomy analgesia. Patients and methods Forty-four patients were divided into two equal groups: one group was given general anesthesia only and the other group given lumbar IT 20 mg bupivacaine plus F 25 microgram (mcg) in lateral position followed by general anesthesia. Results In the IT group, analgesia manifested as delayed request for postoperative analgesia 5 h postinjection; 50% reduction in intraoperative and 24 h postoperative analgesic requirements; low visual analog pain scale, and high range of arm movement in the first 3 h postoperatively. But there was associated intraoperative hypotension and postoperative pruritus. Conclusion Lumbar IT F potentiates analgesia in mastectomy surgery.
ISSN:2356-9115
2356-9123
DOI:10.4103/roaic.roaic_66_17