Comparison of remifentanil and fentanyl for postoperative pain control after abdominal hysterectomy.
OBJECTIVE
In this randomized, double-blind study, we investigated the analgesic efficacy and side effects of continuous constant-dose infusions of remifentanil after total abdominal hysterectomy and compared it to fentanyl.


METHODS
Fifty-six adult female patients scheduled for elective total abdominal hysterectomy were enrolled in this study. Patients were randomly assigned to two groups according to fentanyl (group F, n=28) or remifentanil (group R, n=28) for postoperative analgesia. Patients in group F were given fentanyl intravenously with an infusion rate of fentanyl 0.5 microg/kg/hr; group R was given remifentanil with an infusion rate of remifentanil 0.05 microg/kg/min for 2 days. Pain intensity at rest, occurrence of postoperative nausea and vomiting (PONV), dizziness, pruritus, and respiratory depression were assessed 1 hr after arrival at the post-anesthesia care unit, at 6; 12; 24; and 48 hr post-operation and 6 hr post-infusion of the study drug. Pain was evaluated by using visual analogue scale (VAS; 0-10). The time that patients first requested analgesics was recorded as well as additional analgesics and antiemetics.


RESULTS
There were no significant differences in VAS, time to first postoperative analgesics, and additional analgesics between the 2 groups. The incidences and severities of PONV and opioid related side effects were not different between the groups; however, there were 3 episodes (10.7%) of serious respiratory depression in group R.


CONCLUSIONS
Continuous infusion technique of remifentanil did not reveal any benefits compared to fentanyl. Furthermore, it is not safe for postoperative analgesia in the general ward.
Choi
Seung Ho
SH
Department of Anesthesiology and Pain Medicine, Yonsei University, College of Medicine, 250 Seongsanno, Seodaemun-gu, Seoul 120-752, Korea.
Koo
Bon-Nyeo
BN
Nam
Soon Ho
SH
Lee
Sung Jin
SJ
Kim
Ki Jun
KJ
Kil
Hae Keum
HK
Lee
Ki-Young
KY
Jeon
Dong Hyuk
DH
D000293:Adolescent; D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use; D004334:Drug Administration Schedule; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects*; D007262:Infusions, Intravenous; D008875:Middle Aged; D010149:Postoperative Pain / Q000188:drug therapy* / Q000209:etiology; D010880:Piperidines / Q000008:administration & dosage / Q000627:therapeutic use*; D000077208:Remifentanil; D016896:Treatment Outcome
D000701:Analgesics, Opioid; D010880:Piperidines; D000077208:Remifentanil; D005283:Fentanyl