Effects of intraoperative continuous infusion of low dose remifentanil and intravenous bolus dose of fentanyl on postoperative pain

• Published in: Anesthesia and pain medicine (Korean society of anesthesiologists) pp. 138 - 142
• Main Authors: 정진용, 김종해, 손상혁
• Format: Journal Article
• Language: English
• Published: 대한마취통증의학회 01.04.2011
• Subjects: 마취과학
• ISSN: 1975-5171; 2383-7977

Background: The aim of this study was to evaluate whether continuous infusion of remifentanil during propofol anesthesia could produce opioid-induced hyperalgesia (OIH) and whether an intravenous bolus of fentanyl could control OIH in the management of postoperative pain. Methods: One hundred fifty-nine women undergoing gynecologic surgery were randomly divided into four groups. Group C: nitrous oxide and propofol infusion (3−4 μg/ml, n = 40), Group F: propofol infusion and intravenous bolus administration of fentanyl (1μg/kg)after suturing the peritoneum (n = 40), Group R: propofol and remifentanil infusion (2−4 ng/ml, n = 40) and Group RF: propofol,remifentanil infusion and intravenous bolus administration of fentanyl (n = 39). Patient controlled analgesia was started after the operation. The postoperative visual analog scale (VAS) was measured in the recovery room, then at 2 h, 6 h, 12 h, and 24 h after the operation. Results: The VAS scores for Groups R and F in the recovery room were lower than for group C (P ＜ 0.05), but there were no differences 2 h after the operation. The VAS scores for Group RF 6 h and 12 h after the operation were higher than those for group C (P ＜ 0.05). Conclusions: Our results suggest that low dose (2−4 ng/ml)continuous infusion of remifentanil during propofol anesthesia does not produce marked hyperalgesia. However, an intravenous bolus of fentanyl can aggravate OIH induced by remifentanil. (Anesth Pain Med 2011; 6: 138∼142) KCI Citation Count: 1