NEBULIZED VERSUS INTRAVENOUS FENTANYL FOR POST-OPERATIVE ANALGESIA AFTER UNILATERAL ARTHROSCOPIC ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION SURGERY: A PROSPECTIVE, RANDOMIZED, COMPARATIVE
Ahmed M.Ab Hamed MD., Mohamed A. Elrabey MD. and Ehab Elshahat MD.
Anesthesia and ICU department;Benha university
Abstract
Objectives:This study aimed to compare the effect of nebulised fentanyl with intravenous fentanyl for post-operative analgesia after unilateral arthroscopic anterior cruciate ligament reconstruction surgery.
Patients and methods:87 patients underwent unilateral arthroscopic anterior cruciate ligament reconstruction surgery under regional anaesthesia were enrolled in the study and were randomly allocated into two groups:Group IV: 42 patients received IV fentanyl 2 μg/kg and Group N: 45 patients received 4 μg/kg fentanyl nebulized by a standard ventimask.
Both groups received the analgesic drug by either IV or nebulisation routes whenever the patient complained of pain for the first time of visual analogue scale (VAS) score >4 in PACU.Observation were made for onset and duration of analgesia, number of patients who were not relieved of pain even after 15 min. from start of analgesia, level of sedation by Ramsay sedation scale and side effects.
Results:The groups were similar in terms of demographic characteristics and duration of surgery. The onset of analgesia was significantly delayed in group N in comparison with group IVwhile duration of analgesia was significantly longer in group N in comparison with group IV.In group IV, Ramsay sedation score was the maximum at 5 min. In group N, there was a slow rise in the sedation score but it was always less than in group IV. Side effects in groups N were less compared with group IV, number of patients developed bradycardia were significantly higher in group IV.
Conclusions:This study showed that nebulisation with fentanyl is a good alternative to IV fentanyl for adequate post-operative pain relief with fewer side effects.
Keywords:Nebulized fentanyl, intravenous fentanyl, post-operativ
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