Evaluation of Postoperative Pain Control and Quality of Recovery in Patients Using Intravenous Patient-Controlled Analgesia with Fentanyl: A Prospective Randomized Study.
OBJECTIVE
Opioids are increasingly used to control postoperative pain via intravenous patient-controlled analgesia, with several advantages. The present study evaluated the effects of intravenous patient-controlled analgesia with different doses of fentanyl on postoperative pain and on the quality of physical/emotional recovery from surgery and anesthesia.


METHODS
We retrospectively reviewed data from 288 patients, and evaluated whether intravenous patient-controlled analgesia with fentanyl correlated with the degree of postoperative pain. We then prospectively studied 47 patients who underwent elective laparoscopic cholecystectomy. The patients were randomized into 2 groups (15 or 30 μg/mL of fentanyl), and postoperative pain control was compared using a visual analog scale score. Furthermore, the Japanese 40-item quality of recovery (QoR-40J) score (global and dimensional) and Hospital Anxiety and Depression Scale (HADS) were used to assess the quality of recovery from surgery and anesthesia.


RESULTS
Of 288 patients, 20% complained of intolerable pain and 18% experienced postoperative nausea and vomiting. In the prospective study, the visual analog scale pain score was lower in the Fentanyl 30 group than in the Fentanyl 15 group (p<0.05) on postoperative day 1. Dimensional QoR-40J pain subscales correlated with both the emotional state subscales (postoperative day 1, p<0.05; day 2, p<0.05) and global QoR-40 scores on both postoperative days (day 1, p<0.05; day 2, p<0.05).


CONCLUSIONS
The postoperative pain as well as the physical and emotional quality of recovery in the patients who underwent laparoscopic cholecystectomy could be alleviated by sufficient doses of opioids.
Department of Anesthesiology and Pain Medicine, Graduate School of Medicine, Nippon Medical School.
Hiroe
H
Onaka
Masashi
M
Ishikawa
Yoshiaki
Y
Mizuguchi
Eiji
E
Uchida
Atsuhiro
A
Sakamoto
D061605:Administration, Intravenous; D016058:Analgesia, Patient-Controlled; D000762:Anesthesia Recovery Period; D000932:Antiemetics / Q000627:therapeutic use; D003710:Demography; D005260:Female; D005283:Fentanyl / Q000494:pharmacology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology*; D011182:Postoperative Care; D011446:Prospective Studies; D012189:Retrospective Studies; D011795:Surveys and Questionnaires
D000932:Antiemetics; D005283:Fentanyl