(2014) Intravenous patient-controlled remifentanil versus paracetamol in post-operative pain management in patients undergoing coronary artery bypass graft surgery. Anesthesiology and pain medicine. e19862. ISSN 2228-7523 (Print) 2228-7523 (Linking)
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Abstract
BACKGROUND: Pain management after cardiac surgery has been based on parenteral long-acting opioids such as morphine. The other alternatives are paracetamol and remifentanil. OBJECTIVES: In this prospective, double-blind, randomized study, we compared the efficacy of intravenous patient-controlled analgesia (IV-PCA) paracetamol and remifentanil for post cardiac surgery pain relief. MATERIALS AND METHODS: One-hundred patients scheduled for elective coronary artery bypass grafting from May to October 2011, were randomized into two groups after the surgery. For the first group (group R, n = 50, with mean age of 58.16 +/- 11.80), the IV-PCA protocol was remifentanil infusion 100 mug/h; bolus of 25 mug and lockout time of 15 minutes. In the second group (group P, n = 50, with mean age of 53.8 +/- 15.08), patients received paracetamol 15 mg/kg as a bolus at the end of surgery and then IV-PCA protocol was 100 mug/h, bolus of 25 mug; and lockout time of 15 minutes. Pain was assessed with visual analog scale score (VAS) in the first 24 hours after surgery for seven times. RESULTS: The trend of pain scores did not have any significantly difference between group R and group P except for hour 8 and hour 18 after surgery that VAS was significantly lower in group P than group R (P = 0.031, P = 0.023, respectively). Respiratory rate (RR) was also statistically lower in group R comparing to group P in all seven evaluating times. The groups were similar in terms of hemodynamic, ABG results (except for PaO2, which was significantly lower in group R than group P at 6 evaluating times), intubation time, renal function tests, and incidences of atelectasis, myocardial infarction or adverse effects. CONCLUSIONS: Both PCA techniques provided effective pain scores (< 3) after cardiac surgery; but generally, PCA-paracetamol infusion has a better analgesic effect.
Item Type: | Article |
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Keywords: | Cardiac Surgery Patient-Controlled Analgesia Remifentanil |
Divisions: | |
Page Range: | e19862 |
Journal or Publication Title: | Anesthesiology and pain medicine |
Volume: | 4 |
Number: | 5 |
Identification Number: | 10.5812/aapm.19862 |
ISSN: | 2228-7523 (Print) 2228-7523 (Linking) |
Depositing User: | مهندس مهدی شریفی |
URI: | http://eprints.zbmu.ac.ir/id/eprint/2932 |
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