Fentanyl by Constant Rate I.V. Infusion for Postoperative Analgesia

Nimmo, W.S.; Todd, J.G.

doi:10.1093/bja/57.3.250

Cited by 61 publications

(9 citation statements)

References 7 publications

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“…Other possible methods to chronically treat the coronary artery with IL-1␤ include a transfection of the IL-1␤ gene from the intimal surface using a perforated catheter (18,19) and a chronic intracoronary infusion of IL-1␤ using an osmotic pump (20). However, the former method itself may cause significant endothelial and smooth muscle damage, whereas the latter method requires an Data are expressed as meanϮSEM.…”

Section: Discussionmentioning

confidence: 99%

Chronic treatment with interleukin-1 beta induces coronary intimal lesions and vasospastic responses in pigs in vivo. The role of platelet-derived growth factor.

et al. 1996

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Section: Discussionmentioning

confidence: 99%

Chronic treatment with interleukin-1 beta induces coronary intimal lesions and vasospastic responses in pigs in vivo. The role of platelet-derived growth factor.

et al. 1996

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“…In volunteers and patients, the range of the plasma fentanyl concentration providing analgesia without clinically significant respiratory depression is 0.6-2 ng/ml [9,10]. According to the pharmacokinetics calculation (TIVA Trainer Version 8, Frank Engbers, Leiden, The Netherlands), a bolus of 25 and 50 lg of fentanyl administered intravenously may retain its steady plasma concentration at 0.4 and 0.9 ng/ml for more than 10 min in a patient with an average physique in the F25 and F50 groups, respectively [11].…”

mentioning

confidence: 99%

Comparisons of two different doses of fentanyl for procedural analgesia during epidural catheter placement: a double-blind prospective, randomized, placebo-controlled study

et al. 2010

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The purpose of this study was to investigate the effect of fentanyl on analgesic properties and respiratory responses during an epidural procedure. Sixty patients premedicated with oral brotizolam 0.25 mg were allocated to receive procedural analgesia with saline or 25 or 50 μg of fentanyl. Five minutes after administration, an epidural procedure was started. Pain assessments were made immediately after the epidural catheter placement using a visual analog scale. The lowest SpO₂ levels during the procedure were recorded to evaluate respiratory depression, and cardiovascular complications were also recorded. The pain scores were significantly lower in the 25 and 50 μg fentanyl groups than in the placebo group (P < 0.01). There was no difference in pain assessment between the 25 and 50 μg fentanyl groups. The lowest SpO₂ value of the 50 μg fentanyl group was significantly lower than those of the other groups (P < 0.001). Seven of 20 cases in the 50 μg fentanyl group needed oxygen administration because of a decreased SpO₂ value (<94%). No cardiovascular complications were observed in any group during the entire study period. Thus, intravenous fentanyl at a dose of 25 μg provides effective procedural analgesia without the risk of hypoxemia during an epidural procedure in a patient with preanesthetic medication.

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“…Many reports have documented the relationship between plasma opioid concentration and magnitude of pain reduction in cancer patients with hydromorphone and methadone (Inturrisi et al 1988(Inturrisi et al , 1990, in experimental pain in humans with alfentanil (Hill et al 1986b) and in postoperative pain with a variety of opioids (Austin et al 1980;Berkowitz et al 1975;Nimmo & Todd 1985). In an individual patient there is a plasma opioid concentration below which the analgesic drug produces no pain relief, and above which further increases in concentration produce increasing analgesia.…”

Section: Discussionmentioning

confidence: 99%

A Computer-Based System for Controlling Plasma Opioid Concentration According to Patient Need for Analgesia

Hill

Jacobson

Coda

et al. 1991

Clinical Pharmacokinetics

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Microprocessor-controlled infusion pumps, which allow a patient to self-administer bolus doses of an analgesic to relieve pain, are becoming commonplace. While these patient-controlled analgesia (PCA) systems overcome the large interpatient variations in pharmacokinetics, they do not provide steady relief from pain since they rely on delivering a drug in small, incremental doses. To overcome this problem, the authors developed an algorithm and computer-pump system that allows patients to control their own plasma concentration of analgesic. This approach uses individually predetermined pharmacokinetic parameters to provide steady plasma opioid concentrations that can be increased or decreased by the patient in line with the need for more pain relief or fewer side effects. The control software uses a novel, recursive algorithm to compute the pump rates necessary to maintain constant plasma drug (e.g. morphine) concentrations at desired values and to reach a new steady concentration in response to patient requests. This report describes the mathematical approach to the problem of control of plasma opioid concentration, the application of this new drug delivery system to management of persistent pain in cancer patients undergoing bone marrow transplantation, and the magnitude of pharmacokinetic variability with morphine in this patient population. Results are presented from individual patients using this adjustable drug delivery system continuously for up to 2 weeks to control pain from oral mucositis.

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Fentanyl by Constant Rate I.V. Infusion for Postoperative Analgesia

Cited by 61 publications

References 7 publications

Chronic treatment with interleukin-1 beta induces coronary intimal lesions and vasospastic responses in pigs in vivo. The role of platelet-derived growth factor.

Chronic treatment with interleukin-1 beta induces coronary intimal lesions and vasospastic responses in pigs in vivo. The role of platelet-derived growth factor.

Comparisons of two different doses of fentanyl for procedural analgesia during epidural catheter placement: a double-blind prospective, randomized, placebo-controlled study

A Computer-Based System for Controlling Plasma Opioid Concentration According to Patient Need for Analgesia

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