Epidural vs. intravenous fentanyl during colorectal surgery using a double‐blind, double‐dummy design

Sadurní, M.; Heredia, Sandra; Dürsteler, C.; Pérez-Ramos, A.; Langohr, Klaus; Escolano, F.; Puig, Margarita M.

doi:10.1111/aas.12118

Cited by 10 publications

(7 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It was well-known that both PCEA and PCIA are applicable to the analgesia of spinal fusion, while there remains a controversy for the optimal method for the postoperative pain relief [12,27]. Recently, several previous studies have indicated that PCEA is more effective than PCIA for the analgesia of spinal fusion [28][29][30][31]. Nevertheless, there are also some studies that showed discordant results [14,32,33].…”

Section: Introductionmentioning

confidence: 99%

Comparison of pain relief between patient-controlled epidural analgesia and patient-controlled intravenous analgesia for patients undergoing spinal fusion surgeries

Wang

et al. 2015

Arch Orthop Trauma Surg

View full text Add to dashboard Cite

show abstract

Section: Introductionmentioning

confidence: 99%

Comparison of pain relief between patient-controlled epidural analgesia and patient-controlled intravenous analgesia for patients undergoing spinal fusion surgeries

Wang

et al. 2015

Arch Orthop Trauma Surg

View full text Add to dashboard Cite

show abstract

“…In a human study with fentanyl administered by intravenous route or epidural route, similar sedation results were achieved with both treatments, suggesting that fentanyl might also undergo a rapid systemic uptake (Sadurní and others 2013). Comparably, the rapid systemic effect of epidural methadone may be due to the rapid absorption by blood vessels of the epidural space and rapid distribution into the systemic circulation (Haroutiunian and others 2014).…”

Section: Discussionmentioning

confidence: 90%

“…This shorter duration probably occurred because the authors used half the dose of local anaesthetic bupivacaine in the BupFent treatment than in the Bup treatment. Fentanyl epidural alone (0.002 mg/kg) in human beings had an average analgesic duration of five hours (Sadurní and others 2013), which is more than twice as long as that experienced when the same dose was administered intravenously (two hours). In the present study, the analgesic duration of epidural fentanyl was much shorter.…”

Section: Discussionmentioning

confidence: 99%

Fentanyl and methadone used as adjuncts to bupivacaine for lumbosacral epidural analgesia in sheep

et al. 2017

View full text Add to dashboard Cite

Six healthy, female, mixed-breed 18-24-month-old sheep weighing 30-48 kg were submitted to lumbosacral epidural bupivacaine in combination with either methadone or fentanyl. Epidural catheters were placed in six sheep that were given three treatments: (Bup) bupivacaine (0.5 mg/kg) alone; (BupMet) bupivacaine (0.25 mg/kg) plus methadone (0.3 mg/kg); and (BupFent) bupivacaine (0.25 mg/kg) plus fentanyl (0.002 mg/kg). Haemodynamic variables, respiratory rate, rectal temperature, analgesia by applying a standard painful stimulus, motor block and sedative scores were compared among the three treatments. These parameters were determined before epidural administration and at 5, 10, 20, 30, 60, 90, 120 minutes after treatment administration, and then every 60 minutes thereafter until the end of analgesic effect. Parametrical data were analysed by proc glimmix (SAS) for repeated measures on time and means tested by ls-means. Non-parametrical data were analysed by Fisher's exact test. Duration of analgesia was longer with BupMet (240 minutes) compared with BupFent (180 minutes; P=0.0127), but BupMet was similar to Bup (240 minutes). Both treatments with opioids produced moderate motor blockade. BupMet and BupFent produced mild sedation. Only treatment with bupivacaine alone induced cardiovascular and respiratory rate changes that stayed within acceptable limits.

show abstract

“…There are also contradictory results regarding the effectiveness of epidural vs. intravenous fentanyl [28,29]. Epidural fentanyl has been suggested to have both systemic and spinal actions.…”

Section: Discussionmentioning

confidence: 99%

The effects of epidural versus intravenous patient-controlled analgesia on postoperative outcomes in elderly patients who have undergone gastrectomy: a retrospective trial

Kim¹,

Lee²,

Kang³

et al. 2017

Anesth Pain Med

View full text Add to dashboard Cite

Background: Efforts for improving surgical outcomes in elderly patients should include the prevention of perioperative complications and proper postoperative pain management. Epidural analgesia is effective in decreasing perioperative stress and postoperative complications, and in improving recovery. Recently, it has been suggested that epidural analgesia may attenuate immune suppression during the perioperative period and lead to reductions in cancer recurrence and improvements in overall survival. Assuming that these effects of epidural analgesia are present in vulnerable elderly patients, we compared the efficacy of epidural patient-controlled analgesia and intravenous patientcontrolled analgesia on postoperative outcomes in elderly patients who had undergone gastrectomy. Methods:We evaluated 214 elderly patients who had undergone elective open gastrectomy for gastric cancer from 2011 to 2014. The demographic characteristics, analgesic efficacy, complications within the first 30 postoperative days, hospital stay, 24-month postoperative morbidity, cancer recurrence, and mortality were studied retrospectively.Results: Two-hundred and five patients were analyzed. Eighty-five patients received epidural patient-controlled analgesia (EPCA group) and 120 patients received intravenous patient-controlled analgesia (IVPCA group). The maximum pain scores were decreased to a greater extent in the EPCA group on the day of the operation (P < 0.001) and on the first postoperative day (P = 0.001) when compared to the IVPCA group. The patients in the EPCA group also required less analgesics on the day of the operation (P = 0.033) than those in the IVPCA group. The effect of EPCA on complications within the first 30 postoperative days, 24-month postoperative morbidity, cancer recurrence, and mortality were negligible in our study.Conclusions: EPCA provided more effective pain control than IVPCA in elderly patients who had undergone elective gastric cancer surgery, but did not affect postoperative outcomes.

show abstract

Epidural vs. intravenous fentanyl during colorectal surgery using a double‐blind, double‐dummy design

Abstract: During major abdominal surgery, epidural administration requires lower doses of intraoperative fentanyl when compared with the intravenous route. Epidural fentanyl also facilitates early awakening and residual analgesia without increasing adverse events.

Cited by 10 publications

References 20 publications

Comparison of pain relief between patient-controlled epidural analgesia and patient-controlled intravenous analgesia for patients undergoing spinal fusion surgeries

Comparison of pain relief between patient-controlled epidural analgesia and patient-controlled intravenous analgesia for patients undergoing spinal fusion surgeries

Fentanyl and methadone used as adjuncts to bupivacaine for lumbosacral epidural analgesia in sheep

The effects of epidural versus intravenous patient-controlled analgesia on postoperative outcomes in elderly patients who have undergone gastrectomy: a retrospective trial

Contact Info

Product

Resources

About