Evaluation of pain following electrocautery tubal ligation and effect of intraoperative fentanyl.
OBJECTIVE
To evaluate pain following laparoscopic tubal sterilization (LTS) and the effects of supplemental intraoperative fentanyl.


METHODS
Open evaluation of pain intensity and opioid requirements with double-blind, randomized evaluation of intraoperative fentanyl.


METHODS
Outpatient center of a university-affiliated teaching hospital.


METHODS
44 ASA status I patients who underwent LTS by electrocautery.


METHODS
Patients received either intravenous fentanyl (F) 1 microgram/kg or saline (S) at induction.


RESULTS
Pain intensity was measured with patient assessments of visual analog scales (VAS) and cumulative opioid requirements. The group that received intraoperative fentanyl received 70.2 +/- 3.7 micrograms at induction. VAS on postanesthesia care unit arrival was 4.9 +/- 0.5 (F) and 5.9 +/- 0.5 (S) (means +/- SEM). VAS after one hour was 2.1 +/- 0.2 in both groups. During that hour, the F group consumed 107.5 +/- 14.7 micrograms and the S group consumed 140.5 +/- 15.7 micrograms fentanyl. The range of fentanyl consumed by each group in the postoperative period was 0 to 250 micrograms. There were no statistically significant differences between the F and S groups.


CONCLUSIONS
Pain following LTS by electrocautery is of significant magnitude and may require relatively large doses of opioids for adequate management. Supplemental intraoperative fentanyl 1 microgram/kg did not produce a clinically significant reduction in either pain scores or opioid requirements.
Curry
C S
CS
Department of Anesthesiology, Maine Medical Center, Portland, USA.
Darby
J R
JR
Janssen
B R
BR
D000328:Adult; D018686:Anesthetics, Intravenous; D004311:Double-Blind Method; D004564:Electrocoagulation / Q000009:adverse effects*; D005069:Evaluation Studies as Topic; D005260:Female; D005283:Fentanyl; D006801:Humans; D007430:Intraoperative Care / Q000379:methods; D010535:Laparoscopy / Q000009:adverse effects; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology*; D013246:Sterilization, Tubal / Q000009:adverse effects* / Q000379:methods
D018686:Anesthetics, Intravenous; D005283:Fentanyl