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Patient-controlled Analgesia With Propacetamol-Fentanyl Mixture for Prevention of Postoperative Nausea and Vomiting in High-risk Patients Undergoing Spine Surgery: A Randomized Controlled Trial

 Kim, Eun Jung  ;  Shim, Jae-Kwang  ;  Soh, Sarah  ;  Song, Jong Wook  ;  Lee, Se Ryeon  ;  Kwak, Young-Lan 
 Journal of Neurosurgical Anesthesiology, Vol.28(4) : 316-322, 2016 
Journal Title
 Journal of Neurosurgical Anesthesiology 
Issue Date
Agmatine/pharmacology* ; Animals ; Blotting, Western ; Brain/drug effects* ; Diabetes Mellitus, Experimental ; Disease Models, Animal ; Inflammation/prevention & control* ; Ischemic Attack, Transient/drug therapy* ; Male ; Neuroprotective Agents/pharmacology* ; Rats ; Rats, Sprague-Dawley ; Real-Time Polymerase Chain Reaction
agmatine ; diabetes ; inflammation ; innate immunity ; ischemia-reperfusion injury
BACKGROUND: This randomized trial evaluated the effect of intravenous patient-controlled analgesia (IV-PCA) based on fentanyl mixed with either propacetamol or an equivalent volume of normal saline on postoperative nausea and vomiting (PONV) in highly susceptible patients undergoing spinal surgery. MATERIALS AND METHODS: One hundred eight nonsmoking female patients were randomly and evenly allocated to receive IV-PCA with either propacetamol (4 g) or normal saline mixed to fentanyl (20 μg/kg). Primary study outcome was PONV incidence at 24 hours postsurgery. Secondary outcomes were nausea severity, pain intensity (100-mm visual analog scale), use of rescue antiemetics and analgesics, patient satisfaction, and adverse events at 6, 12, and 24 hours postsurgery. RESULTS: Postsurgery, the propacetamol versus normal saline group had lower PONV incidence at 24 hours (41% vs. 66%, P=0.011); pain intensity at rest and rescue analgesic requirements at 6 to 12 hours (30±15 vs. 41±19, P=0.008; and 25% vs. 49%, P=0.036, respectively) and at 12 to 24 hours (25±15 vs. 35±17, P=0.008; and 19% vs. 42%, P=0.044, respectively); and higher patient satisfaction score (6.4±1.4 vs. 5.7±1.8, P=0.028). CONCLUSIONS: In patients undergoing spinal surgery and at risk of developing PONV, continuous IV-PCA based on propacetamol mixed to fentanyl, relative to fentanyl alone, effectively reduced the incidence of PONV, pain intensity at rest, and additional use of rescue analgesics with higher patient satisfaction.
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1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
곽영란(Kwak, Young Lan) ORCID logo https://orcid.org/0000-0002-2984-9927
김은정(Kim, Eun Jung) ORCID logo https://orcid.org/0000-0002-5693-1336
소사라(Soh, Sa Rah) ORCID logo https://orcid.org/0000-0001-5022-4617
송종욱(Song, Jong Wook) ORCID logo https://orcid.org/0000-0001-7518-2070
심재광(Shim, Jae Kwang) ORCID logo https://orcid.org/0000-0001-9093-9692
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