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Comparison of the efficacy of IV-PCA between Fentanyl and Morphine after burn necrosis excision and skin graft surgery
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Tóm tắt
Objectives: To compare the postoperative analgesic efficacy of IV-PCA Fentanyl with Morphine in patients undergoing burn necrosis excision and skin graft surgery.
Subjects and methods: A comparative prospective study was conducted in 70 burn cases divided into 2 groups with 35 cases in each group having indications for burn necrosis excision and skin graft surgery. After the surgery, they were given IV-PCA Fentanyl (group F) or morphine (group M) for postoperative pain control. When the patients were painful (VAS ≥ 4), analgesics were titrated as following: In the group F, 0.025mg Fentanyl was intravenously injected and repeated every 5min until VAS < 4, then IV-PCA was started. The total titration dose of Fentanyl was below 0.1mg.
In group M, 1mg Morphine was intravenously injected and repeated every 5 minutes until VAS < 4, then IV-PCA was started. The total titration dose of Morphine was below 10mg. IV-PCA setting were bolus 1ml (Fentanyl 0.025mg or Morphine 1mg), lockout time 10min, basal continuous infusion 1ml/h (Fentanyl 0.025mg/h or Morphine 1mg/h), maximum dosage 15ml/4h (Fentanyl 0.375mg/4h or Morphine 15mg/4h).
Results: In group F, the minimum and maximum of the visual analog scores (VAS) at rest after started IV-PCA were 2.03 ± 0.17 and 2.23 ± 0.64, respectively. In group M, minimum and maximum VAS at rest after started IV-PCA were 2.03 ± 0.2 and 2.14 ± 0.4, respectively. In group F, minimum and maximum VAS on movement after started IV-PCA were 3.03 ± 0.17 and 3.14 ± 0.49, respectively. In group M, minimum and maximum VAS on movement after started IV-PCA were 3.03 ± 0.2 and 3.23 ± 0.6, respectively. VAS at rest and on movement were statistically insignificant differences between the two groups (p > 0.05). The proportion of unsatisfied patients in group F was statistically significantly lower than that in group M (5.7% versus 20%) (p < 0.05).
Conclusions: The analgesic efficacy of IV-PCA between Fentanyl and Morphine after burn necrosis excision and skin graft surgery was similar but the only proportion of satisfied patients in the IV-PCA Fentanyl group was higher than that in the IV-PCA Morphine group.
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Từ khóa
Fentanyl, Morphine, IV-PCA, burn necrosis excision and skin graft
Tài liệu tham khảo
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