Effects of Intraoperative Opioid Administration on Postoperative Pain and Pain Threshold: A Randomized Controlled Study

被引:3
作者
Kawanaka, Ryoko [1 ]
Sakuma, Shoko [1 ]
Kokubun, Hiroshi [1 ]
Tetsu, Shuhei [1 ]
Tagaito, Yugo [1 ]
Igarashi, Toshio [2 ]
Liang, Shan-Guang [2 ]
Aoe, Tomohiko [3 ]
机构
[1] Teikyo Univ, Dept Anesthesiol, Chiba Med Ctr, 3426-3 Anesaki, Ichihara, Chiba 2990111, Japan
[2] Teikyo Univ, Dept Obstet & Gynecol, Chiba Med Ctr, 3426-3 Anesaki, Ichihara, Chiba 2990111, Japan
[3] Teikyo Univ, Pain Ctr, Chiba Med Ctr, 3426-3 Anesaki, Ichihara, Chiba 2990111, Japan
基金
日本学术振兴会;
关键词
postoperative pain; opioid-induced hyperalgesia; opioid misuse; fentanyl; remifentanil; INDUCED HYPERALGESIA; FIBROMYALGIA; TOLERANCE; PHARMACOKINETICS; SURGERY;
D O I
10.3390/jcm11195587
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Fentanyl and short-acting remifentanil are often used in combination. We evaluated the effect of intraoperative opioid administration on postoperative pain and pain thresholds when the two drugs were used. Patients who underwent gynecological laparoscopic surgery were randomly assigned into two groups (15 patients each) to receive either sufficient (group A) or minimum (group B) fentanyl (maximum estimated effect site concentration: A: 7.86 ng/mL, B: 1.5 ng/mL). The estimated effect site concentration at the end of surgery was adjusted to the same level (1 ng/mL). Patients in both groups also received continuous intravenous remifentanil during surgery. The primary outcome was the pressure pain threshold, as evaluated by a pressure algometer 3 h postoperatively. The pressure pain threshold at 3 h postoperatively was 51.1% (95% CI: [44.4-57.8]) in group A and 56.6% [49.5-63.6] in group B, assuming a preoperative value of 100% (p = 0.298). There were no significant differences in pressure pain threshold and numeric rating scale scores between the groups after surgery. The pain threshold decreased significantly in both groups at 3 h postoperatively compared to preoperative values, and recovered at 24 h. Co-administration of both opioids caused hyperalgesia regardless of fentanyl dose.
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页数:12
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共 41 条
  • [1] Opioid-Prescribing Patterns of Emergency Physicians and Risk of Long-Term Use
    Barnett, Michael L.
    Olenski, Andrew R.
    Jena, Anupam B.
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 2017, 376 (07) : 663 - 673
  • [2] Using Policy Tools to Improve Population Health - Combating the US Opioid Crisis
    Barry, Colleen L.
    Saloner, Brendan
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 2021, 385 (23) : 2113 - 2116
  • [3] Postsurgical prescriptions for opioid naive patients and association with overdose and misuse: retrospective cohort study
    Brat, Gabriel A.
    Agniel, Denis
    Beam, Andrew
    Yorkgitis, Brian
    Bicket, Mark
    Homer, Mark
    Fox, Kathe P.
    Knecht, Daniel B.
    McMahill-Walraven, Cheryl N.
    Palmer, Nathan
    Kohane, Isaac
    [J]. BMJ-BRITISH MEDICAL JOURNAL, 2018, 360
  • [4] Src Kinase Inhibition Attenuates Morphine Tolerance without Affecting Reinforcement or Psychomotor Stimulation
    Bull, Fiona A.
    Baptista-Hon, Daniel T.
    Sneddon, Claire
    Wright, Lisa
    Walwyn, Wendy
    Hales, Tim G.
    [J]. ANESTHESIOLOGY, 2017, 127 (05) : 878 - 889
  • [5] Correlation Between 24-Hour Predischarge Opioid Use and Amount of Opioids Prescribed at Hospital Discharge
    Chen, Eric Y.
    Marcantonio, Andrew
    Tornetta, Paul, III
    [J]. JAMA SURGERY, 2018, 153 (02)
  • [6] Perioperative opioid analgesia-when is enough too much? A review of opioid-induced tolerance and hyperalgesia
    Colvin, Lesley A.
    Bull, Fiona
    Hales, Tim G.
    [J]. LANCET, 2019, 393 (10180) : 1558 - 1568
  • [7] Drug Enforcement Administration U.S. Department of Justice, DEA RES GUID, V2020th ed.
  • [8] G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences
    Faul, Franz
    Erdfelder, Edgar
    Lang, Albert-Georg
    Buchner, Axel
    [J]. BEHAVIOR RESEARCH METHODS, 2007, 39 (02) : 175 - 191
  • [9] Opioid-induced hyperalgesia in patients after surgery: a systematic review and a meta-analysis
    Fletcher, D.
    Martinez, V.
    [J]. BRITISH JOURNAL OF ANAESTHESIA, 2014, 112 (06) : 991 - 1004
  • [10] The pharmacological basis of opioids
    Ghelardini, Carla
    Mannelli, Lorenzo Di Cesare
    Bianchi, Enrica
    [J]. CLINICAL CASES IN MINERAL AND BONE METABOLISM, 2015, 12 (03) : 219 - 221