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Immediate postoperative pain management in patients undergoing major abdominal surgery after remifentanil-based anesthesia: sufentanil vs tramadol.
Minerva Anestesiol. 2004 Sep; 70(9):661-9.MA

Abstract

AIM

The transition from intraoperative analgesia to postoperative analgesia must be planned carefully after remifentanil-based anesthesia, due to the short duration of action of remifentanil. The aim of this study is to compare the efficacy and safety of 2 transition strategies using sufentanil or tramadol for early postoperative pain relief in patients who had major abdominal surgery under general anesthesia with remifentanil/sevoflurane.

METHODS

Sixty patients participated in this double-blind, prospective study and were randomly assigned to either sufentanil (S) group or tramadol (T) group. Twenty minutes before the end of surgery the patients received either a bolus of 0.15 microg kg(-1) sufentanil (group S) or tramadol 100 mg (group T). Mean arterial pressure (MAP), heart rate (HR) and rate pressure product (RPP=systolic arterial pressure (SAP)xHR), analgesia by a verbal rating score (VRS) and sedation by a sedation score (SS) were evaluated at emergence from anesthesia.

RESULTS

A statistically significant difference in HR between the 2 groups was recorded at extubation (78+/-13 in group S vs 86+/-24 in group T). A significant decrease of RPP values at extubation and 5 minutes later were found in group S in comparison with group T. VRS values were significantly lower in sufentanil group at 5 and 10 minutes after awakening.

CONCLUSIONS

Sufentanil provided more effective transition analgesia in comparison with tramadol. The effects of remifentanil dissipated rapidly and analgesia with major opioids was required. A bolus dose of sufentanil 0.15 microg kg(-1) was efficacious in controlling the hemodynamic parameters at awakening from anesthesia. The lower HR values and, consequently the lower RPP values are of utmost importance especially in the aged cardiovascular risk patient.

Authors+Show Affiliations

Department of Anesthesia, Postoperative Intensive Care, Burn Center and Hyperbaric Center A. Cardarelli Hospital, Naples, Italy. tcafiero@tiscali.itNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng ita

PubMed ID

15467498

Citation

Cafiero, T, et al. "Immediate Postoperative Pain Management in Patients Undergoing Major Abdominal Surgery After Remifentanil-based Anesthesia: Sufentanil Vs Tramadol." Minerva Anestesiologica, vol. 70, no. 9, 2004, pp. 661-9.
Cafiero T, Di Minno RM, Sivolella G, et al. Immediate postoperative pain management in patients undergoing major abdominal surgery after remifentanil-based anesthesia: sufentanil vs tramadol. Minerva Anestesiol. 2004;70(9):661-9.
Cafiero, T., Di Minno, R. M., Sivolella, G., & Di Iorio, C. (2004). Immediate postoperative pain management in patients undergoing major abdominal surgery after remifentanil-based anesthesia: sufentanil vs tramadol. Minerva Anestesiologica, 70(9), 661-9.
Cafiero T, et al. Immediate Postoperative Pain Management in Patients Undergoing Major Abdominal Surgery After Remifentanil-based Anesthesia: Sufentanil Vs Tramadol. Minerva Anestesiol. 2004;70(9):661-9. PubMed PMID: 15467498.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Immediate postoperative pain management in patients undergoing major abdominal surgery after remifentanil-based anesthesia: sufentanil vs tramadol. AU - Cafiero,T, AU - Di Minno,R M, AU - Sivolella,G, AU - Di Iorio,C, PY - 2004/10/7/pubmed PY - 2005/1/6/medline PY - 2004/10/7/entrez SP - 661 EP - 9 JF - Minerva anestesiologica JO - Minerva Anestesiol VL - 70 IS - 9 N2 - AIM: The transition from intraoperative analgesia to postoperative analgesia must be planned carefully after remifentanil-based anesthesia, due to the short duration of action of remifentanil. The aim of this study is to compare the efficacy and safety of 2 transition strategies using sufentanil or tramadol for early postoperative pain relief in patients who had major abdominal surgery under general anesthesia with remifentanil/sevoflurane. METHODS: Sixty patients participated in this double-blind, prospective study and were randomly assigned to either sufentanil (S) group or tramadol (T) group. Twenty minutes before the end of surgery the patients received either a bolus of 0.15 microg kg(-1) sufentanil (group S) or tramadol 100 mg (group T). Mean arterial pressure (MAP), heart rate (HR) and rate pressure product (RPP=systolic arterial pressure (SAP)xHR), analgesia by a verbal rating score (VRS) and sedation by a sedation score (SS) were evaluated at emergence from anesthesia. RESULTS: A statistically significant difference in HR between the 2 groups was recorded at extubation (78+/-13 in group S vs 86+/-24 in group T). A significant decrease of RPP values at extubation and 5 minutes later were found in group S in comparison with group T. VRS values were significantly lower in sufentanil group at 5 and 10 minutes after awakening. CONCLUSIONS: Sufentanil provided more effective transition analgesia in comparison with tramadol. The effects of remifentanil dissipated rapidly and analgesia with major opioids was required. A bolus dose of sufentanil 0.15 microg kg(-1) was efficacious in controlling the hemodynamic parameters at awakening from anesthesia. The lower HR values and, consequently the lower RPP values are of utmost importance especially in the aged cardiovascular risk patient. SN - 0375-9393 UR - https://www.unboundmedicine.com/medline/citation/15467498/Immediate_postoperative_pain_management_in_patients_undergoing_major_abdominal_surgery_after_remifentanil_based_anesthesia:_sufentanil_vs_tramadol_ L2 - http://www.minervamedica.it/index2.t?show=R02Y2004N09A0661 DB - PRIME DP - Unbound Medicine ER -