Postoperative analgesia with epidural fentanyl

A retrospective analysis of 133 patients who received continuous epidural fentanyl for postoperative analgesia is presented. Using a concentration of 5 micrograms/mL of fentanyl, patients received continuous epidural infusions for 24 to 72 hours postoperatively. The average rate of infusion was 60 micrograms/h. A total of 59.3% of the patients received no additional narcotics; 26.3% required supplemental narcotics during the first 24 hours only. Three percent had the infusion discontinued because it provided poor pain control. Side effects were less than, or comparable to, those of epidural morphine. Respiratory depression, defined as a respiratory rate of less than 8, or apnea did not occur. Urinary retention occurred in one patient. Pruritus occurred in 4% (6 patients). Nausea occurred in 25.5%, a rate comparable to that which occurred with epidural morphine. No side effects occurred in 70.6% of the patients reviewed. These data show that epidural fentanyl provides good to excellent pain relief with minimal side effects.