Intravenous patient-controlled analgesia to manage the postoperative pain in patients undergoing craniotomy

This randomized controlled study evaluated the efficacy of intravenous patient-controlled analgesia (IV-PCA) with fentanyl and ketorolac for neurosurgical patients, and compared the effectiveness of IV-PCA with intermittent analgesics injection. The patients undergoing craniotomy were randomly assig...

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Published inKorean journal of anesthesiology Vol. 60; no. 1; pp. 30 - 35
Main Authors An, Sang-Bum, Park, Hee-Pyoung, Lim, Young-Jin, Hwang, Jung-Won, Jeon, Young-Tae, Min, Seong-Won
Format Journal Article
LanguageEnglish
Published Korea (South) The Korean Society of Anesthesiologists 2011
Korean Society of Anesthesiologists
대한마취통증의학회
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ISSN2005-6419
2005-7563
2005-7563
DOI10.4097/kjae.2011.60.1.30

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Summary:This randomized controlled study evaluated the efficacy of intravenous patient-controlled analgesia (IV-PCA) with fentanyl and ketorolac for neurosurgical patients, and compared the effectiveness of IV-PCA with intermittent analgesics injection. The patients undergoing craniotomy were randomly assigned to two groups. Patients of group P (n = 53) received fentanyl (0.2 µg/kg/hr) and ketorolac (0.3 mg/kg/hr) via IV-PCA, and those of group N (n = 53) received intermittent fentanyl or ketorolac injection as needed. Pain was evaluated using a 0-10 visual analogue scale (VAS) at postoperative 1, 4, and 24 hr. The amount of infused analgesic drugs, Glasgow Coma Scale (GCS) score, systolic arterial pressure, heart rate, respiratory rate, and the incidence of nausea and miosis were measured at the same time points. Although VAS of pain (VASp) was comparable at postoperative 1 hr (P = 0.168) between the two groups, the group P had significantly lower VASp at postoperative 4 hr (P = 0.007) and 24 hr (P = 0.017). In group P, less analgesic drugs were administered at postoperative 1 hr, and more analgesic drugs were administered at postoperative 24 hr. There were no differences between two groups with respect to nausea, GCS, systolic arterial pressure, and heart rate. IV-PCA did not further incur respiratory depression or miosis. IV-PCA with fentanyl and ketorolac after craniotomy is more effective analgesic technique, without adverse events, than the intermittent administration of analgesics.
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ISSN:2005-6419
2005-7563
2005-7563
DOI:10.4097/kjae.2011.60.1.30