A comparison of sufentanil and fentanyl for patient-controlled epidural analgesia in arthroplasty

Background: The use of lipid soluble opioids such as fentanyl, alfentanil and sufentanil are recently on the increase for patient-controlled epidural analgesia (PCEA). In this study, the effects and adequate dose of sufentanil in arthroplasty were investigated. Methods: Eighty patients scheduled for arthroplasty were enrolled for the study. Seventy-one patients (ASA physical status I-III) were randomly allocated into four groups. All groups received 0.1% ropivacaine through PCEA and each group received either fentanyl (group F: fentanyl 4 mu g/ml) or sufentanil (group S1: sufentanil 0.5 mu g/ml, group S2: sufentanil 0.75 mu g/ml, and group S3: sufentanil 1.0 mu g/ml). Postoperative pain scores were evaluated using VAS (visual analog scale, 0-10) and side effects such as hypotension, nausea/vomiting, pruritus and the degree of satisfaction were evaluated at 1, 6, 12, 24, 48 hours after surgery. Results: Postoperative pain score (VAS) decreased gradually and the highest VAS score was recorded at 1 hour postoperative for all four groups. There were no differences in the degree of satisfaction and postoperative pain score between all groups. The incidence of pruritus was significantly lower in group S1 than in groups S2 and S3. Conclusions: The incidence of side effects were significantly lower in group S1 (0.1% ropivacaine plus sufentanil 0.5 mu g/ml). Therefore, 0.5 mu g/ml of sufentanil through PCEA is the recommended dose for postoperative pain control in arthroplasty.