J Korean Neurosurg Soc.  2017 Jan;60(1):54-59. 10.3340/jkns.2016.0707.007.

Comparison of the Effects of Sufentanil and Fentanyl Intravenous Patient Controlled Analgesia after Lumbar Fusion

• Kim DK
• Yoon SH
• Kim JY
• Oh CH
• Jung JK
• Kim J

• KMID: 2365587
• DOI: http://doi.org/10.3340/jkns.2016.0707.007

Abstract

OBJECTIVE
Postoperative pain is one of the major complaints of patients after lumbar fusion surgery. The authors evaluated the effects of intravenous patient controlled analgesia (IV-PCA) using fentanyl or sufentanil on postoperative pain management and pain-related complications.
METHODS
Forty-two patients that had undergone surgery with lumbar instrumentation and fusion at single or double levels constituted the study cohort. Patients were equally and randomly allocated to a sufentanil group (group S) or a fentanyl group (group F) for patient controlled analgesia (PCA). Group S received sufentanil at a dose of 4 μg/kg IV-PCA and group F received fentanyl 24 μg/kg IV-PCA. A numeric rating scale (NRS) of postoperative pain was applied before surgery, and immediately and at 1, 6, and 24 hours (hrs) after surgery. Oswestry disability index (ODI) scores were obtained before surgery and one month after surgery. Opioid-related side effects were also evaluated.
RESULTS
No significant intergroup difference was observed in NRS or ODI scores at any of the above-mentioned time points. Side effects were more frequent in group F. More specifically, nausea, vomiting rates were significantly higher (p=0.04), but pruritus, hypotension, and headache rates were non-significantly different in the two groups.
CONCLUSION
Sufentanil displayed no analgesic advantage over fentanyl postoperatively. However, sufentanil should be considerable for patients at high risk of GI issues, because it had lower postoperative nausea and vomiting rates than fentanyl.

Keyword

Postoperative pain; Lumbar fusion; Sufentanil; Fentanyl; IV-PCA

MeSH Terms

Analgesia, Patient-Controlled*
Cohort Studies
Fentanyl*
Headache
Humans
Hypotension
Nausea
Pain, Postoperative
Postoperative Nausea and Vomiting
Pruritus
Sufentanil*
Vomiting
Fentanyl
Sufentanil

Figure

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  Fig. 1 NRS scores in the two study groups. NRS: numeric rating scale.

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  Fig. 2 Group ODI scores. ODI: Oswestry disability index.

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  Fig. 3 Frequencies of NRS assessed pain severities after surgery in the study groups. NRS: numeric rating scale.

Reference

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