Epidural vs. intravenous fentanyl during colorectal surgery using a double-blind, double-dummy design

Background The overall therapeutic effectiveness of epidural fentanyl vs. the intravenous route is controversial. The present work describes a randomized, controlled, double‐blind, double‐dummy study of the intraoperative requirements of fentanyl administered by the intravenous or epidural routes du...

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Bibliographic Details
Published in:Acta anaesthesiologica Scandinavica 2013-10, Vol.57 (9), p.1103-1110
Main Authors: SADURNÍ, M., BELTRÁN DE HEREDIA, S., DÜRSTELER, C., PÉREZ-RAMOS, A., LANGOHR, K., ESCOLANO, F., PUIG, M. M.
Format: Article
Language:English
Subjects:
Aged
Analgesia, Epidural - methods
Analgesia, Patient-Controlled
Analgesics, Opioid - administration & dosage
Analgesics, Opioid - adverse effects
Anesthesia, General
Anesthesia, Intravenous - methods
Anesthetics, Intravenous - administration & dosage
Anesthetics, Intravenous - adverse effects
Colon - surgery
Colonic Neoplasms - surgery
Double-Blind Method
Female
Fentanyl - administration & dosage
Fentanyl - adverse effects
Follow-Up Studies
Humans
Intraoperative Period
Male
Monitoring, Intraoperative
Pain, Postoperative - drug therapy
Propofol - administration & dosage
Rectum - surgery
Sample Size
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Summary:Background The overall therapeutic effectiveness of epidural fentanyl vs. the intravenous route is controversial. The present work describes a randomized, controlled, double‐blind, double‐dummy study of the intraoperative requirements of fentanyl administered by the intravenous or epidural routes during open colon surgery. Methods Thirty patients were randomized to receive intraoperative analgesia with boluses of fentanyl administered by either the epidural or intravenous route (2 μg/kg). The first fentanyl bolus was administered 10 min before incision, and repeated boluses were given when mean arterial pressure or heart rate increased more than 20% over basal values. General anaesthesia was maintained with a propofol infusion. Intraoperative fentanyl and propofol requirements, time to awakening, time to analgesia request, and incidence of adverse effects were recorded. Results Median [interquartile range (range)] fentanyl requirements in the epidural and intravenous groups were 0.81 [0.65 (0.47–2.61)] and 2.5 [1.08 (1.07–4.85)] μg/kg/h, respectively (P 
ISSN:0001-5172
1399-6576
DOI:10.1111/aas.12118