title: [Comparative study of epidural and intravenous fentanyl for postoperative analgesia of orthopedic surgeries.].
abstract: OBJECTIVE
  There are controversies about the action site of lipophylic opioids after epidural injection. Some authors believe that these drugs act at supraspinal level, while others propose a spinal action. This comparative study aimed at answering this question by comparing epidural and intravenous fentanyl for postoperative analgesia of lower limb orthopedic procedures.
  
  
  METHODS
  This was a randomized double-blind study. At postoperative pain complaint, G1 patients (n = 14) received 5 mL epidural solution (100 microg fentanyl in 0.9% saline) and 2 mL of intravenous 0.9% saline; G2 patients (n = 15) received 5 mL epidural 0.9% saline and 2 mL intravenous fentanyl (100 microg). Analgesic complementation with intravenous tenoxicam (40 mg) and epidural 0.25% bupivacaine (5 mL) (when there was no relief with tenoxicam) has been evaluated. Pain intensity was evaluated by numeric and verbal scales in moments M30, M120 and M240 minutes.
  
  
  RESULTS
  Number of patients needing analgesic complementation both with tenoxicam (G1 = 10 and G2 = 15 patients) and bupivacaine (G1 = 2 and G2 = 8 patients) has been higher in G2. There have been no statistical differences in pain intensity between groups in all studied moments.
  
  
  CONCLUSIONS
  In the conditions of our study, effects of epidural fentanyl were better as compared to intravenous fentanyl.
authors.affiliation: Universidade Federal de São Paulo.
authors.forename: Marcelo Soares
authors.initials: MS
authors.lastname: Privado
authors.forename: Rioko Kimiko
authors.initials: RK
authors.lastname: Sakata
authors.forename: Adriana Machado
authors.initials: AM
authors.lastname: Issy
authors.forename: João Batista Santos
authors.initials: JB
authors.lastname: Garcia