Korean J Anesthesiol.  2004 Apr;46(4):434-438. 10.4097/kjae.2004.46.4.434.

Effects of Ondansetron or Naloxone Patient-Controlled Analgesia on Postoperative Analgesia and Side Effects

• Han DW
• Chang CH
• Lee JS
• Shim KD
• Noh JS
• Lee YW

• KMID: 2299055
• DOI: http://doi.org/10.4097/kjae.2004.46.4.434

Abstract

BACKGROUND
Opioid delivered by PCA (patient-controlled analgesia) is effective at relieving pain after surgery, but it is associated with side effects, such as nausea, vomiting, pruritus, respiratory depression, and urinary retention. The purpose of this study was to compare fentanyl-related side effects and the quality of analgesia when naloxone or ondansetron was added to IV PCA regimen.
METHODS
Ninety patients undergoing lumbar laminectomy were enrolled in this study. General anesthesia was maintained with 50% N2O and enflurane. In the recovery room patients received a 1microgram/kg bolus of fentanyl, and addition normal saline 2 ml (group C), ondansetron 4 mg (group O), or naloxone 0.04 mg (group N). Simultaneously intravenous fentanyl PCA with normal saline (group C), ondansetron 4 mg (group O), or naloxone 0.36 mg (group N) was commenced. Pain scores and side effects were assessed on postoperative days (PODs) 0, 1, and 2 using a VAS (visual analogue scale).
RESULTS
The incidences of vomiting in the groups C, O, and N were 13.2%, 13.2%, and 3.3%, respectively. The VAS scores for nausea on PODs 0 and 1 in group N were significantly lower than in group C. The VAS scores for sedation on POD 0 in group N was lower than in group C, and on POD 2 lower than in group O. No differences in the VAS for pain and urinary retention were observed between the three groups.
CONCLUSIONS
Low-dose naloxone with IV fentanyl PCA is effective at reducing opioid-related nausea and sedation without attenuating the quality of analgesia.

Keyword

fentanyl; naloxone; ondansetron; patient-controlled analgesia

MeSH Terms

Analgesia*
Analgesia, Patient-Controlled*
Anesthesia, General
Enflurane
Fentanyl
Humans
Incidence
Laminectomy
Naloxone*
Nausea
Ondansetron*
Passive Cutaneous Anaphylaxis
Pruritus
Recovery Room
Respiratory Insufficiency
Urinary Retention
Vomiting
Enflurane
Fentanyl
Naloxone
Ondansetron