Continuous intravenous analgesia with fentanyl or morphine after gynecological surgery: a cohort study

Purpose This retrospective study aims to compare postoperative pain relief offered by continuous intravenous infusion of either fentanyl or morphine. Methods Sixty American Society of Anesthesiologists Physical Status I and II women who had undergone open gynecological surgery were enrolled. All pat...

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Bibliographic Details
Published in:Journal of anesthesia 2017-02, Vol.31 (1), p.51-57
Main Authors: Russo, Andrea, Grieco, Domenico Luca, Bevilacqua, Francesca, Anzellotti, Gian Marco, Scarano, Annamaria, Scambia, Giovanni, Costantini, Barbara, Marana, Elisabetta
Format: Article
Language:English
Subjects:
Adult
Analgesia, Patient-Controlled
Analgesics, Opioid - administration & dosage
Analgesics, Opioid - adverse effects
Analgesics, Opioid - therapeutic use
Analysis
Anesthesiology
Cohort Studies
Conscious Sedation
Critical Care Medicine
Emergency Medicine
Endpoint Determination
Female
Fentanyl - administration & dosage
Fentanyl - adverse effects
Fentanyl - therapeutic use
Gynecologic Surgical Procedures
Humans
Infusions, Intravenous
Intensive
Length of Stay
Medical societies
Medicine
Medicine & Public Health
Middle Aged
Morphine
Morphine - administration & dosage
Morphine - therapeutic use
Original Article
Pain management
Pain Measurement
Pain Medicine
Pain, Postoperative - drug therapy
Pilot Projects
Retrospective Studies
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Summary:Purpose This retrospective study aims to compare postoperative pain relief offered by continuous intravenous infusion of either fentanyl or morphine. Methods Sixty American Society of Anesthesiologists Physical Status I and II women who had undergone open gynecological surgery were enrolled. All patients received total intravenous postoperative analgesia for 24 h with continuous infusion of either fentanyl or morphine at comparable doses (38 patients received 0.3 µg/kg/h fentanyl and 22 received 0.02 mg/kg/h morphine). The primary endpoint was the need for analgesic rescue therapy during the postoperative period as assessed by an experienced nurse blinded to the design of the study, while the time to gastrointestinal bowel recovery was the main safety outcome measure. Visual analog scale was used to evaluate postoperative pain. Ramsay sedation score, multiparametric monitoring, bowel function and adverse effects were also recorded at 1, 6, 12, 18 and 24 h after the end of surgery. Results Data analysis showed that four patients (10 %) in the fentanyl group versus eight patients (36 %) in the morphine group needed to be treated with analgesic rescue drugs [unadjusted OR for fentanyl 0.2 (0.05–0.80); p  = 0.02]. Patients treated with fentanyl showed a faster gastrointestinal recovery [1 (1–2) vs 3 (2.7–4) days; p  
ISSN:0913-8668
1438-8359
DOI:10.1007/s00540-016-2268-0