[Comparative study of postoperative analgesia with methadone and fentanyl in continuous peridural perfusion].
OBJECTIVE
To determine whether continuous epidural perfusion of fentanyl, which is more liposoluble than methadone, provides a similar level of analgesia with fewer side effects than methadone administered by the same route for postoperative pain.


METHODS
Prospective double blind study of 40 patients, randomly assigned to two groups. Group F (n = 20) received 300 micrograms-1200 micrograms/24 h in epidural perfusion. Group M (n = 20) received 9 mg-18 mg/24 h in epidural perfusion. In both cases treatment was for pain in the first 72 h after abdominal surgery. Analgesia quality was evaluated on a visual analog (VAS) scale from 1 to 10 at rest and moving. Need for complementary analgesia was also recorded, as were side effects related to the technique.


RESULTS
Quality of analgesia was good and similar which both drugs. Postoperative pain did not surpass 3 on the VAS at rest or 4.5 while moving, although group F patients' need for complementary analgesia was significantly greater (p < 0.05). The incidence of hypoxemia was greater in group M than in group F (p = 0.05).


CONCLUSIONS
Continuous epidural perfusion of fentanyl provides good analgesia and is associated with less hypoxemia than is methadone.
Prieto-Alvarez
M P
MP
Servicio de Anestesiología, Reanimación y Clínica del Dolor, Pius Hospital, Valls., Tarragona.
Fuentes-Bellido
J G
JG
López-Cebollada
J
J
Lorenzo-Foz
J P
JP
D000005:Abdomen / Q000601:surgery; D000328:Adult; D000368:Aged; D015360:Analgesia, Epidural; D000701:Analgesics, Opioid; D004311:Double-Blind Method; D005260:Female; D005283:Fentanyl; D006801:Humans; D008297:Male; D008691:Methadone; D008875:Middle Aged; D010149:Postoperative Pain / Q000517:prevention & control*; D011446:Prospective Studies
D000701:Analgesics, Opioid; D008691:Methadone; D005283:Fentanyl