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[Comparative study of postoperative analgesia with methadone and fentanyl in continuous peridural perfusion]
M P Prieto-Alvarez1, J G Fuentes-Bellido, J López-Cebollada
1Servicio de Anestesiología, Reanimación y Clínica del Dolor, Pius Hospital, Valls., Tarragona.
Objective:
To determine whether continuous epidural perfusion of fentanyl, which is more liposoluble than methadone, provides a similar level of analgesia with fewer side effects than methadone administered by the same route for postoperative pain.
Patients And Methods:
Prospective double blind study of 40 patients, randomly assigned to two groups. Group F (n = 20) received 300 micrograms-1200 micrograms/24 h in epidural perfusion. Group M (n = 20) received 9 mg-18 mg/24 h in epidural perfusion. In both cases treatment was for pain in the first 72 h after abdominal surgery. Analgesia quality was evaluated on a visual analog (VAS) scale from 1 to 10 at rest and moving. Need for complementary analgesia was also recorded, as were side effects related to the technique.
Results:
Quality of analgesia was good and similar which both drugs. Postoperative pain did not surpass 3 on the VAS at rest or 4.5 while moving, although group F patients' need for complementary analgesia was significantly greater (p < 0.05). The incidence of hypoxemia was greater in group M than in group F (p = 0.05).
Conclusions:
Continuous epidural perfusion of fentanyl provides good analgesia and is associated with less hypoxemia than is methadone.