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Comparison of remifentanil and fentanyl for postoperative pain control after abdominal hysterectomy

Authors
 Seung Ho Choi  ;  Bon-Nyeo Koo  ;  Soon Ho Nam  ;  Sung Jin Lee  ;  Ki Jun Kim  ;  Hae Keum Kil  ;  Ki-Young Lee  ;  Dong Hyuk Jeon 
Citation
 YONSEI MEDICAL JOURNAL, Vol.49(1) : 204-210, 2008 
Journal Title
YONSEI MEDICAL JOURNAL
ISSN
 0513-5796 
Issue Date
2008
MeSH
Adolescent ; Adult ; Aged ; Analgesics, Opioid/administration & dosage ; Analgesics, Opioid/therapeutic use ; Drug Administration Schedule ; Female ; Fentanyl/administration & dosage ; Fentanyl/therapeutic use* ; Humans ; Hysterectomy/adverse effects* ; Infusions, Intravenous ; Middle Aged ; Pain, Postoperative/drug therapy* ; Pain, Postoperative/etiology ; Piperidines/administration & dosage ; Piperidines/therapeutic use* ; Remifentanil ; Treatment Outcome
Keywords
Adolescent ; Adult ; Aged ; Analgesics, Opioid/administration & dosage ; Analgesics, Opioid/therapeutic use ; Drug Administration Schedule ; Female ; Fentanyl/administration & dosage ; Fentanyl/therapeutic use* ; Humans ; Hysterectomy/adverse effects* ; Infusions, Intravenous ; Middle Aged ; Pain, Postoperative/drug therapy* ; Pain, Postoperative/etiology ; Piperidines/administration & dosage ; Piperidines/therapeutic use* ; Remifentanil ; Treatment Outcome
Abstract
PURPOSE: In this randomized, double-blind study, we investigated the analgesic efficacy and side effects of continuous constant-dose infusions of remifentanil after total abdominal hysterectomy and compared it to fentanyl.

MATERIALS AND METHODS: Fifty-six adult female patients scheduled for elective total abdominal hysterectomy were enrolled in this study. Patients were randomly assigned to two groups according to fentanyl (group F, n=28) or remifentanil (group R, n=28) for postoperative analgesia. Patients in group F were given fentanyl intravenously with an infusion rate of fentanyl 0.5 microg/kg/hr; group R was given remifentanil with an infusion rate of remifentanil 0.05 microg/kg/min for 2 days. Pain intensity at rest, occurrence of postoperative nausea and vomiting (PONV), dizziness, pruritus, and respiratory depression were assessed 1 hr after arrival at the post-anesthesia care unit, at 6; 12; 24; and 48 hr post-operation and 6 hr post-infusion of the study drug. Pain was evaluated by using visual analogue scale (VAS; 0-10). The time that patients first requested analgesics was recorded as well as additional analgesics and antiemetics.

RESULTS: There were no significant differences in VAS, time to first postoperative analgesics, and additional analgesics between the 2 groups. The incidences and severities of PONV and opioid related side effects were not different between the groups; however, there were 3 episodes (10.7%) of serious respiratory depression in group R.

CONCLUSION: Continuous infusion technique of remifentanil did not reveal any benefits compared to fentanyl. Furthermore, it is not safe for postoperative analgesia in the general ward.
Files in This Item:
T200803301.pdf Download
DOI
10.3349/ymj.2008.49.2.204
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Koo, Bon-Nyeo(구본녀) ORCID logo https://orcid.org/0000-0002-3189-1673
Kil, Hae Keum(길혜금)
Kim, Ki Jun(김기준) ORCID logo https://orcid.org/0000-0003-1950-7998
Nam, Soon Ho(남순호)
Lee, Ki Young(이기영) ORCID logo https://orcid.org/0000-0003-4893-3195
Lee, Sung Jin(이성진)
Choi, Seung Ho(최승호) ORCID logo https://orcid.org/0000-0001-8442-4406
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/108110
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