title: Effects of fentanyl on procedural pain and discomfort associated with central venous catheter insertion: A prospective, randomized, double-blind, placebo controlled trial.
abstract: BACKGROUND
  Central venous catheter (CVC) insertion induces pain and discomfort to a conscious patient despite application of a local anesthetic (LA) field block and this pain can be greatly lessened by using additional analgesics.
  
  
  OBJECTIVE
  The aim of this study is to evaluate the efficacy of fentanyl along with LA field infiltration in controlling pain and discomfort associated with CVC insertion.
  
  
  METHODS
  A prospective, randomized, double-blind, placebo-controlled trial was conducted at tertiary referral center.
  
  
  METHODS
  Fifty-four patients scheduled for planned CVC were randomly assigned to receive either fentanyl (2 μg/kg) or 0.9% normal saline. Pain and discomfort using a verbal numeric rating pain scale at 5 times points during CVC insertion were assessed and analyzed.
  
  
  RESULTS
  The median interquartile range pain score is worst for placebo group after LAI (5 [3-6]) and in the immediate postprocedure period (5 [4-5]) which was significantly attenuated by addition of fentanyl (3.5 [2-5] and 3 [2-4]) (P = 0.009 and 0.001 respectively). Overall, fentanyl and placebo group were not statistically different with median discomfort score except at T10 (P = 0.047).
  
  
  CONCLUSIONS
  Preprocedural bolus fentanyl infusion provides adequate analgesia and can be safely used for alleviating pain during CVC insertion in conscious patients.
authors.affiliation: Department of Anaesthesiology and Critical Care, Sri Venkateswara Institute of Medical Sciences, SVIMS University, Tirupati, Andhra Pradesh, India.
authors.forename: Aloka
authors.initials: A
authors.lastname: Samantaray
authors.affiliation: Department of Anaesthesiology and Critical Care, Sri Venkateswara Institute of Medical Sciences, SVIMS University, Tirupati, Andhra Pradesh, India.
authors.forename: Mangu Hanumantha
authors.initials: MH
authors.lastname: Rao
keywords: Analgesia; central venous catheter; fentanyl; procedural pain
references.citation: J Postgrad Med. 1998 Jul-Sep;44(3):57-62
references.pmid: 10703572
references.citation: Anesthesiology. 1980 Sep;53(3):250-3
references.pmid: 6968520
references.citation: Ann Card Anaesth. 2007 Jan;10(1):42-5
references.pmid: 17455407
references.citation: Anesthesiology. 1991 Nov;75(5):790-5
references.pmid: 1952204
references.citation: J Clin Psychopharmacol. 1990 Aug;10(4):244-51
references.pmid: 2286697
references.citation: Am J Crit Care. 1994 Mar;3(2):116-22
references.pmid: 7513228
references.citation: J Pain Symptom Manage. 1998 Feb;15(2):91-101
references.pmid: 9494307
references.citation: Anaesth Intensive Care. 1984 May;12(2):113-4
references.pmid: 6383116
references.citation: Acad Emerg Med. 1996 Feb;3(2):142-6
references.pmid: 8808375
references.citation: Am J Crit Care. 2001 Jul;10(4):238-51
references.pmid: 11432212
references.citation: J Clin Anesth. 2011 Jun;23(4):286-91
references.pmid: 21663812
references.citation: Anesth Analg. 1979 Sep-Oct;58(5):390-5
references.pmid: 314761
references.citation: Br J Anaesth. 1988 May;60(6):608-13
references.pmid: 3377942
references.citation: Surg Clin North Am. 1999 Apr;79(2):231-52
references.pmid: 10352653
references.citation: Am J Crit Care. 2002 Sep;11(5):415-29; quiz 430-1
references.pmid: 12233967