Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 1.736
5-Year Impact Factor – 2.135
Index Copernicus  – 168.52
MEiN – 70 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

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Advances in Clinical and Experimental Medicine

2010, vol. 19, nr 6, November-December, p. 739–743

Publication type: original article

Language: English

The Effectivity of Fentanyl Versus Tramadol as Intravenous Patient-Controlled Analgesia After Cesarean Section

Skuteczność fentanylu i tramadolu jako dożylnego znieczulenia kontrolowanego przez pacjentkę po cięciu cesarskim

Ayten Saracoglu1,, Kemal T. Saracoglu1,, Tumay Umuroglu2,, Abdulkadir But1,

1 Division of Pain Medicine, Department of Anesthesiology, Central Education and Research Hospital, Erzurum, Turkey

2 Division of Pain Medicine, Department of Anesthesiology, Medical School of Marmara University, Istanbul, Turkey

Abstract

Background. Patient-controlled analgesia (PCA) is the most widely used treatment method for post-cesarean section pain.
Objectives. To compare two different opioids with respect to analgesic quality and side effects.
Material and Methods. Sixty patients undergoing elective cesarean surgery were enrolled into two groups. Group F (n = 30) had postoperative IV PCA with fentanyl and Group T (n = 30) had IV PCA with tramadol. Postoperative pain scores, opioid requirements, side effects and patient satisfaction were compared.
Results. The patient demographics were similar in both groups. Group F patients consumed 638.4 ± 179 μg of fentanyl, and Group T patients consumed 559.5 ± 207 mg of tramadol. The number of patients requiring additional opioid was similar in both groups. Patient satisfaction did not differ in the two groups.
Conclusion. Both fentanyl and tramadol provide sufficient postoperative analgesia and patient satisfaction when used in PCA.

Streszczenie

Wprowadzenie. Leczenie bólu kontrolowane przez pacjenta (PCA) jest najczęściej stosowaną metodą leczenia bólu po cesarskim cięciu.
Cel pracy. Porównanie dwóch różnych opioidów w odniesieniu do działania przeciwbólowego i działań niepożądanych.
Materiał i metody. Sześćdziesiąt pacjentek poddanych planowemu cięciu cesarskiemu zakwalifikowano do dwóch grup. W grupie F (n = 30) zastosowano dożylne znieczulenie kontrolowane przez pacjentkę (PCA) fentanylem pooperacyjnie i w grupie T (n = 30) dożylne PCA tramadolem. Porównano ocenę bólu pooperacyjnego, wymagania opioidów, skutki uboczne i zadowolenie pacjentek.
Wyniki. Wskaźniki demograficzne pacjentek były podobne w obu grupach. Grupa F otrzymała 638,4 ± 179 mg fentanylu, a grupa T 559,5 ± 207 mg tramadolu. Liczba pacjentek wymagających dodatkowych opioidów była podobna w obu grupach. Satysfakcja pacjentek nie różniła się w obu grupach.
Wnioski. Zarówno fentanyl, jak i tramadol użyty w PCA daje wystarczające znieczulenie pooperacyjne i zadowolenie matek.

Key words

analgesia, patient-controlled; postoperative pain, cesarean section, fentanyl, tramadol

Słowa kluczowe

znieczulenie kontrolowane przez pacjenta, ból pooperacyjny, cięcie cesarskie, fentanyl, tramadol

References (18)

  1. Mota FA, Marcolan JF, Pereira MH, Milanez AM, Dallan LA, Diccini S: Comparison study of two different patient-controlled anesthesia regiments after cardiac surgery. Rev Bras Cir Cardiovasc 2010, 25, 38–44.
  2. Prakash S, Fatima T, Pawar M: Patient-Controlled Analgesia with Fentanyl for Burn Dressing Changes. Anesth Analg 2004, 99, 552–555.
  3. Roussier M, Mahul P, Pascal J: Patient-controlled cervical epidural fentanyl compared with patient-controlled i.v. fentanyl for pain after pharyngolaryngeal surgery. Br J Anaesth 2006, 96, 492–496.
  4. Chazan S, Buda I, Nesher N, Paz J, Weinbroum AA: Low-Dose Ketamine via Intravenous Patient-Controlled Analgesia Device After Various Transthoracic Procedures Improves Analgesia and Patient and Family Satisfaction. Pain Manag Nurs 2010, 11, 169–176.
  5. Ko JS, Choi SJ, Gwak MS, Kim GS, Ahn HJ, Kim JA, Hahm TS: Intrathecal morphine combined with intravenous patient-controlled analgesia is an effective and safe method for immediate postoperative pain control in live liver donors. Liver Transpl 2009, 15, 381–389.
  6. Baltali S, Turkoz A, Bozdogan N, Demirturk OS, Baltali M, Turkoz R, Arslan G: The efficacy of intravenous patient-controlled remifentanil versus morphine anesthesia after coronary artery surgery. J Cardiothorac Vasc Anesth 2009, 23, 170–174.
  7. De Cosmo G, Congedo E, Lai C, Primieri P, Dottarelli A, Aceto P: Preoperative psychologic and demographic predictors of pain perception and tramadol consumption using intravenous patient-controlled analgesia. Clin J Pain 2008, 24, 399–405.
  8. Baraka A, Siddik S, Assaf B: Supplementation of general anaesthesia with tramadol or fentanyl in parturients undergoing elective caesarean section. Can J Anaesth 1998, 45, 631–634.
  9. Fleckenstein J, Kramer S, Offenbächer M, Schober G, Plischke H, Siebeck M, Mussack T, Hatz R, Lehmeyer L, Lang PM, Heindl B, Conzen P, Irnich D: Etoricoxib – preemptive and postoperative analgesia (EPPA) in patients with laparotomy or thoracotomy – design and protocols. Trials 2010, 27, 11–66.
  10. Savoia G, Alampi D, Amantea B, Ambrosio F, Arcioni R, Berti M, Bettelli G, Bertini L, Bosco M, Casati A, Castelletti I, Carassiti M, Coluzzi F, Costantini A, Danelli G, Evangelista M, Finco G, Gatti A, Gravino E, Launo C, Loreto M, Mediati R, Mokini Z, Mondello E, Palermo S, Paoletti F, Paolicchi A, Petrini F, Piacevoli Q, Rizza A, Sabato AF, Santangelo E, Troglio E, Mattia C: Postoperative pain treatment SIAARTI Recommendations 2010. Short version. Minerva Anestesiol 2010, 76, 657–667.
  11. Buvanendran A, Kroin JS: Multimodal analgesia for controlling acute postoperative pain. Curr Opin Anaesthesiol 2009, 22, 588–593.
  12. Reuben SS, Connelly NR: Postoperative analgesic effects of celecoxib or rofecoxib after spinal fusion surgery. Anesth Analg 2000, 91, 1221–1225.
  13. Karamanlioglu B, Turan A, Memis D, Ture M: Preoperative Oral Rofecoxib Reduces Postoperative Pain and Tramadol Consumption in Patients After Abdominal Hysterectomy Anesth Analg 2004, 98, 1039–1043.
  14. Sudheer PS, Logan SW, Terblanche C, Ateleanu B, Hall JE: Comparison of the analgesic efficacy and respiratory effects of morphine, tramadol and codeine after craniotomy. Anaesthesia 2007, 62, 555–560.
  15. Hadi MA, Kamaruljan HS, Saedah A, Abdullah NM: A comparative study of intravenous patient-controlled analgesia morphine and tramadol in patients undergoing major operation. Med J Malaysia 2006, 61, 570–576.
  16. Ng KF, Yuen TS, Ng VM: A comparison of postoperative cognitive function and pain relief with fentanyl or tramadol patient-controlled analgesia. J Clin Anesth 2006, 18, 205–210.
  17. Kocabas S, Karaman S, Uysallar E, Firat V: The use of tramadol and morphine for pain relief after abdominal hysterectomy. Clin Exp Obstet Gynecol 2005, 32, 45–48.
  18. Chiaretti A, Genovese O, Antonelli A, Tortorolo L, Ruggiero A, Focarelli B, Di Rocco C: Patient-controlled analgesia with fentanil and midazolam in children with postoperative neurosurgical pain. Childs Nerv Syst 2008, 24, 119–124.