Intraoperative and Postoperative Intravenous Fentanyl Analgesia and Management of Postoperative Complications

• Published in: Nihon Rinshō Masui Gakkai shi Vol. 24; no. 10; pp. 655 - 664
• Main Authors: KANDATSU, Nobuhisa, SHIBATA, Yasuyuki, HIROKAWA, Mitsuru, HORIBA, Kiyoshi, KOMATSU, Toru
• Format: Journal Article
• Language: Japanese; English
• Published: THE JAPAN SOCIETY FOR CLINICAL ANESTHESIA 2004
• Subjects: Continuous Intravenous Administration; Fentanyl; Postoperative Analgesia
• ISSN: 0285-4945; 1349-9149
• DOI: 10.2199/jjsca.24.655

Background : Postoperative analgesia may improve postoperative outcome and have appreciable effect on the surgical stress response. Operative and postoperative analgesia has become a major concern for anesthesiologists. We have reviewed the efficacy and side effects of continuous intravenous fentanyl with disposable infusion pump for postoperative pain relief. Method : Five hundred five patients received postoperative continuous intravenous fentanyl with disposable infusion pump for pain relief between January 2002 and December 2002. Four hundred fifty-seven of these patients for whom complete outcome data were available were enrolled for the study. Postoperative pain relief, the level of consciousness, respiratory and cardiovascular depression, nausea, and vomiting were evaluated retrospectively. Results : Upon arrival to the ward, 299 patients (65.4%) had clear consciousness, 148 (32.4%) somnolence, and 10 (2.2%) poor recovery. Three patients (0.7%) were delirious. Seventeen patients (3.7%) had airway obstruction and airway opening maneuvers was needed for 5 of these patients. Two patients (0.4%) had apnea for short period. Twenty patients (4.4%) had SpO2 less than 90% either with or without face-mask oxygen delivery. Ten patients (2.2%) and 43 (9.4%) had a heart-rate of less than 50 bpm, and systolic blood pressure less than 90 mmHg, respectively. Seventy-seven patients (21%) had postoperative nausea and 55 (12%) vomiting. Pain scores were satisfactory in approximately half of the total patients without the supplement of the postoperative analgesics. Thirty-four patients (7.2%) required a supplement of other analgesics more than 3 times during postoperative 24 hours. Conclusion : Intraoperative and postoperative continuous intravenous fentanyl analgesia is an easy and reliable option for postoperative analgesia as an alternative to the epidural analgesia.