title: [Postoperative analgesia of continuous intravenous fentanyl or dexmedetomidine for patients receiving anticoagulant therapy].
abstract: BACKGROUND
  It is difficult to achieve good postoperative analgesia in patients who undergo abdominal aortic surgery without epidural analgesia and who have a bleeding tendency or are undergoing anticoagulation therapy. Intravenous fentanyl analgesia can be used in such patients, but it occasionally causes respiratory depression. Dexmedetomidine is used to achieve postoperative sedation and analgesia without respiratory depression. We compared the methods used to achieve postoperative analgesia after abdominal aortic surgery.
  
  
  METHODS
  In the intravenous fentanyl analgesia group (group F, n = 15), 0.5 microg x kg(-1) x hr(-1) fentanyl infusion was initiated during operation and continued to the next morning. In the intravenous dexmedetomidine group (group D, n = 15), 0.4-0.7 microg x kg(-1) x hr(-1) dexmedetomidine infusion was commenced during the operation and decreased to 0.2-0.7 microg x kg(-1) x hr- in the next morning. In the control group (group C, n = 15), continuous intravenous analgesia was not used. The frequency of analgesic use, Ramsay score, PaCO2 value, and rate of nausea and shivering were evaluated on the next morning.
  
  
  RESULTS
  The frequency of analgesic use and Ramsay score were similar in groups F and D. The Paco2 value was higher in group F than group D.
  
  
  CONCLUSIONS
  With regard to respiratory depression, intravenous dexmedetomidine analgesia is safer and more useful than intravenous fentanyl analgesia.
authors.affiliation: Department of Anesthesiology & Critical Care Medicine, Asahikawa Medical College, Asahikawa 078-8510.
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Onodera
authors.forename: Akio
authors.initials: A
authors.lastname: Yamagishi
authors.forename: Takayuki
authors.initials: T
authors.lastname: Kunisawa
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kurosawa
authors.forename: Osamu
authors.initials: O
authors.lastname: Takahata
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Iwasaki
mesh_terms: D000368:Aged; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage*; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects; D000768:Anesthesia, General; D000925:Anticoagulants / Q000009:adverse effects; D001012:Aorta, Abdominal / Q000601:surgery; D020927:Dexmedetomidine / Q000008:administration & dosage*; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000517:prevention & control*; D012131:Respiratory Insufficiency / Q000139:chemically induced; D014656:Vascular Surgical Procedures
chemical_list: D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid; D000925:Anticoagulants; D020927:Dexmedetomidine; D005283:Fentanyl