Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Comparison of the Effects of Sufentanil and Fentanyl Intravenous Patient Controlled Analgesia after Lumbar Fusion

  • Kim, Do Keun (Department of Neurosurgery, Inha University Hospital) ;
  • Yoon, Seung Hwan (Department of Neurosurgery, Inha University Hospital) ;
  • Kim, Ji Yong (Department of Neurosurgery, Na-Eun Hospital) ;
  • Oh, Chang Hyun (Department of Neurosurgery, Guro Cham TeunTeun Hospital) ;
  • Jung, Jong Kwon (Department of Anesthesiology, Inha university Hospital) ;
  • Kim, Jin (Department of Anesthesiology, Inha university Hospital)
  • Received : 2016.07.19
  • Accepted : 2016.09.22
  • Published : 2017.01.01
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Abstract

Objective : Postoperative pain is one of the major complaints of patients after lumbar fusion surgery. The authors evaluated the effects of intravenous patient controlled analgesia (IV-PCA) using fentanyl or sufentanil on postoperative pain management and pain-related complications. Methods : Forty-two patients that had undergone surgery with lumbar instrumentation and fusion at single or double levels constituted the study cohort. Patients were equally and randomly allocated to a sufentanil group (group S) or a fentanyl group (group F) for patient controlled analgesia (PCA). Group S received sufentanil at a dose of $4{\mu}g/kg$ IV-PCA and group F received fentanyl $24{\mu}g/kg$ IV-PCA. A numeric rating scale (NRS) of postoperative pain was applied before surgery, and immediately and at 1, 6, and 24 hours (hrs) after surgery. Oswestry disability index (ODI) scores were obtained before surgery and one month after surgery. Opioid-related side effects were also evaluated. Results : No significant intergroup difference was observed in NRS or ODI scores at any of the above-mentioned time points. Side effects were more frequent in group F. More specifically, nausea, vomiting rates were significantly higher (p=0.04), but pruritus, hypotension, and headache rates were non-significantly different in the two groups. Conclusion : Sufentanil displayed no analgesic advantage over fentanyl postoperatively. However, sufentanil should be considerable for patients at high risk of GI issues, because it had lower postoperative nausea and vomiting rates than fentanyl.

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References

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