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Comparative Analysis of Nebulized Versus Intravenous Fentanyl for Pain Control After Tonsillectomy: A Double-Blind,
Chanitda Pantabtim1, Saowapark Chumpathong1, Phongthara Vichitvejpaisal1
1Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
The Annals of Otology, Rhinology, and Laryngology
|June 14, 2024
Summary
Nebulized fentanyl offers longer pain relief after tonsillectomy compared to intravenous fentanyl. This study found nebulized fentanyl provided extended analgesia with similar onset and side effect profiles, suggesting it as a viable alternative for post-tonsillectomy pain management.
Area of Science:
- Anesthesiology and Pain Management
- Pharmacology
- Surgical Recovery
Background:
- Effective pain management after tonsillectomy is critical for patient recovery.
- Fentanyl is a potent analgesic, but its nebulized form for post-tonsillectomy pain is understudied.
- This research investigates nebulized versus intravenous fentanyl for post-tonsillectomy pain.
Purpose of the Study:
- To compare the analgesic efficacy of nebulized fentanyl versus intravenous fentanyl.
- To evaluate the onset time of pain relief for both administration routes.
- To assess and compare the incidence of complications associated with each fentanyl administration method.
Main Methods:
- A randomized controlled trial involving adult patients undergoing tonsillectomy.
- Patients received either intravenous fentanyl (1 mcg/kg) or nebulized fentanyl (4 mcg/kg) when pain scores exceeded three.
- Pain levels, time to next analgesia request, and complications were monitored for 24 hours.
Main Results:
- The nebulizer group experienced a significantly longer duration before requiring the next analgesia (median 683.5 min vs. 326.7 min for IV group, P=.009).
- No significant differences were observed in the time to achieve adequate pain control (pain score < 4) between the groups.
- The incidence of side effects, including respiratory depression and nausea, was similar in both the nebulized and intravenous fentanyl groups.
Conclusions:
- Nebulized fentanyl provides a longer duration of analgesia compared to intravenous fentanyl for post-tonsillectomy pain.
- The onset time and side effect profiles are comparable between nebulized and intravenous fentanyl.
- Nebulized fentanyl presents a promising alternative for effective post-tonsillectomy pain management.
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