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Revista Brasileira de Anestesiologia
On-line version ISSN 1806-907X
PRIVADO, Marcelo Soares; SAKATA, Rioko Kimiko; ISSY, Adriana Machado and GARCIA, João Batista Santos. Comparative study of epidural and intravenous fentanyl for postoperative analgesia of orthopedic surgeries. Rev. Bras. Anestesiol. [online]. 2004, vol.54, n.5, pp. 634-639. ISSN 1806-907X. http://dx.doi.org/10.1590/S0034-70942004000500003.
BACKGROUND AND OBJECTIVES: There are controversies about the action site of lipophylic opioids after epidural injection. Some authors believe that these drugs act at supraspinal level, while others propose a spinal action. This comparative study aimed at answering this question by comparing epidural and intravenous fentanyl for postoperative analgesia of lower limb orthopedic procedures. METHODS: This was a randomized double-blind study. At postoperative pain complaint, G1 patients (n = 14) received 5 mL epidural solution (100 µg fentanyl in 0.9% saline) and 2 mL of intravenous 0.9% saline; G2 patients (n = 15) received 5 mL epidural 0.9% saline and 2 mL intravenous fentanyl (100 µg). Analgesic complementation with intravenous tenoxicam (40 mg) and epidural 0.25% bupivacaine (5 mL) (when there was no relief with tenoxicam) has been evaluated. Pain intensity was evaluated by numeric and verbal scales in moments M30, M120 and M240 minutes. RESULTS: Number of patients needing analgesic complementation both with tenoxicam (G1 = 10 and G2 = 15 patients) and bupivacaine (G1 = 2 and G2 = 8 patients) has been higher in G2. There have been no statistical differences in pain intensity between groups in all studied moments. CONCLUSIONS: In the conditions of our study, effects of epidural fentanyl were better as compared to intravenous fentanyl.
Keywords : ANALGESIA [Postoperative]; ANALGESICS [Opioids]; ANALGESICS [fentanyl]; ANESTHETIC TECHNIQUES [Regional]; ANESTHETIC TECHNIQUES [epidural]; ANESTHETIC TECHNIQUES [intravenous].