Revista Brasileira de Anestesiologia
On-line version ISSN 1806-907X
ISSY, Adriana Machado et al. Residual analgesic effect of fentanyl in patients undergoing myocardial revascularization with cardiopulmonary bypass. Rev. Bras. Anestesiol. [online]. 2002, vol.52, n.5, pp. 562-569. ISSN 1806-907X. http://dx.doi.org/10.1590/S0034-70942002000500006.
BACKGROUND AND OBJECTIVES: In spite of the frequent use of high doses of fentanyl for major surgeries, the correlation of its residual plasma concentration to postoperative analgesia deserves further investigation. This study aimed at evaluating the residual analgesic effect of fentanyl in the first and second postoperative days of myocardial revascularization, as well as quantifying its concentration. METHODS: Participated in this study 11 patients undergoing myocardial revascularization with cardiopulmonary bypass under general anesthesia with 50 µg.kg-1 intravenous fentanyl. Analgesia was evaluated by a numeric verbal scale at moments zero (extubation), 70 min, 3, 5, 8 and 12 hours in the first day; and moments zero (24 h after extubation), 70 min, 3, 5, 8 and 12 hours in second post-operative day. Pain intensity to vigorous cough and respiratory physical therapy was evaluated. At every measurement, patients were asked about the need for analgesic complementation. Plasma samples were collected in moments zero (extubation), 70 min, 3, 5, 8 and 12 hours during the first and second postoperative days for fentanyl radioimmunoassay. RESULTS: Mean pain intensity varied from 1.9 to 3.7 in the first day and from 2.1 to 3.8 in the second postoperative day. Fentanyl plasma levels (> 1 ng/ml) evidenced its contribution to post-operative analgesia during the first postoperative day. CONCLUSIONS: In spite of the lack of correlation between residual fentanyl plasma concentration and pain intensity, patients referred only mild pain during the whole investigation period.
Keywords : ANALGESICS [Opioids]; ANALGESICS [fentanyl]; MEASUREMENT TECHNIQUES [numeric verbal scale]; PAIN [Acute]; PAIN [postoperative]; SURGERY [Cardiac]; SURGERY [myocardial revascularization].