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Postoperative analgesia after total hip arthroplasty: patient-controlled analgesia versus transdermal fentanyl patch.
J Clin Anesth. 2008 Jun; 20(4):280-3.JC

Abstract

STUDY OBJECTIVE

To determine whether a new transdermal fentanyl patch (TFP) is a good choice for the postoperative pain management of patients undergoing primary total hip arthroplasty compared with patient-controlled analgesia (PCA).

DESIGN

Randomized, prospective study.

SETTING

University hospital.

PATIENTS

30 patients undergoing primary total hip arthroplasty.

INTERVENTIONS

Patients received either a TFP (group T; Duragesic 50 microg/h, matrix fentanyl patch, Janssen-Cilag) applied approximately 10 hours before induction of general anesthesia and PCA programmed in the postanesthesia care unit (PACU), or PCA programmed in the PACU (group P).

MEASUREMENTS

Intraoperative sufentanil and additional postoperative morphine administration were recorded, as well as visual analog scores and routine vital signs at predetermined intervals during the first 48 hours.

MAIN RESULTS

Morphine consumption on arrival in the PACU was 3.5+/-3 mg in group T versus 13+/-5 mg in group P (P<0.0001). Visual analog scores on arrival in the PACU were 37+/-22 mm in group T versus 73+/-13 mm in group P (P<0.0001). Cumulative morphine consumption at the 24th hour was 43+/-16 mg in group P and 4+/-3 mg in group T (P<0.0001). Cumulative morphine consumption at the 48th hour was 54+/-26 mg in group P and 5+/-4 mg in group T (P<0.0001). Intraoperative sufentanil consumption was 38+/-15 microg in group T versus 30+/-5 microg in group P (not significant). The sedation score was 0 in both groups during the first 48 postoperative hours.

CONCLUSIONS

Preoperative TFP application decreases pain scores and morphine consumption in the PACU and appears to have prolonged effects spanning the first 48 postoperative hours.

Authors+Show Affiliations

Department of Anesthesiology and Intensive Care, GRCB 48, Toulouse University Hospital, University Paul Sabatier, 31403 Toulouse, France. vincentminville@yahoo.frNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

18617126

Citation

Minville, Vincent, et al. "Postoperative Analgesia After Total Hip Arthroplasty: Patient-controlled Analgesia Versus Transdermal Fentanyl Patch." Journal of Clinical Anesthesia, vol. 20, no. 4, 2008, pp. 280-3.
Minville V, Lubrano V, Bounes V, et al. Postoperative analgesia after total hip arthroplasty: patient-controlled analgesia versus transdermal fentanyl patch. J Clin Anesth. 2008;20(4):280-3.
Minville, V., Lubrano, V., Bounes, V., Pianezza, A., Rabinowitz, A., Gris, C., Samii, K., & Fourcade, O. (2008). Postoperative analgesia after total hip arthroplasty: patient-controlled analgesia versus transdermal fentanyl patch. Journal of Clinical Anesthesia, 20(4), 280-3. https://doi.org/10.1016/j.jclinane.2007.12.013
Minville V, et al. Postoperative Analgesia After Total Hip Arthroplasty: Patient-controlled Analgesia Versus Transdermal Fentanyl Patch. J Clin Anesth. 2008;20(4):280-3. PubMed PMID: 18617126.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Postoperative analgesia after total hip arthroplasty: patient-controlled analgesia versus transdermal fentanyl patch. AU - Minville,Vincent, AU - Lubrano,Vincent, AU - Bounes,Vincent, AU - Pianezza,Antoine, AU - Rabinowitz,Anna, AU - Gris,Claude, AU - Samii,Kamran, AU - Fourcade,Olivier, PY - 2006/11/29/received PY - 2007/11/20/revised PY - 2007/12/06/accepted PY - 2008/7/12/pubmed PY - 2008/12/17/medline PY - 2008/7/12/entrez SP - 280 EP - 3 JF - Journal of clinical anesthesia JO - J Clin Anesth VL - 20 IS - 4 N2 - STUDY OBJECTIVE: To determine whether a new transdermal fentanyl patch (TFP) is a good choice for the postoperative pain management of patients undergoing primary total hip arthroplasty compared with patient-controlled analgesia (PCA). DESIGN: Randomized, prospective study. SETTING: University hospital. PATIENTS: 30 patients undergoing primary total hip arthroplasty. INTERVENTIONS: Patients received either a TFP (group T; Duragesic 50 microg/h, matrix fentanyl patch, Janssen-Cilag) applied approximately 10 hours before induction of general anesthesia and PCA programmed in the postanesthesia care unit (PACU), or PCA programmed in the PACU (group P). MEASUREMENTS: Intraoperative sufentanil and additional postoperative morphine administration were recorded, as well as visual analog scores and routine vital signs at predetermined intervals during the first 48 hours. MAIN RESULTS: Morphine consumption on arrival in the PACU was 3.5+/-3 mg in group T versus 13+/-5 mg in group P (P<0.0001). Visual analog scores on arrival in the PACU were 37+/-22 mm in group T versus 73+/-13 mm in group P (P<0.0001). Cumulative morphine consumption at the 24th hour was 43+/-16 mg in group P and 4+/-3 mg in group T (P<0.0001). Cumulative morphine consumption at the 48th hour was 54+/-26 mg in group P and 5+/-4 mg in group T (P<0.0001). Intraoperative sufentanil consumption was 38+/-15 microg in group T versus 30+/-5 microg in group P (not significant). The sedation score was 0 in both groups during the first 48 postoperative hours. CONCLUSIONS: Preoperative TFP application decreases pain scores and morphine consumption in the PACU and appears to have prolonged effects spanning the first 48 postoperative hours. SN - 0952-8180 UR - https://www.unboundmedicine.com/medline/citation/18617126/Postoperative_analgesia_after_total_hip_arthroplasty:_patient_controlled_analgesia_versus_transdermal_fentanyl_patch_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0952-8180(08)00071-8 DB - PRIME DP - Unbound Medicine ER -