A Randomized, Double-Blinded Comparison of Intrathecal Morphine, Sufentanil and their Combination versus IV Morphine Patient-Controlled Analgesia for Postthoracotomy Pain

Liu, Ngai; Kuhlman, G; Dalibon, Nicolas; Moutafis, M.; Levron, Jean-Claude; Fischler, Marc

doi:10.1097/00000539-200101000-00007

Cited by 65 publications

(38 citation statements)

References 18 publications

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“…This study was powered to detect a sparing effect on intraoperative intravenous sufentanil consumption based on Liu's et al study. 3 However, the main difference is that we used a smaller dose of ITS compared to Liu's report (10 vs 50 µg). We chose this dose based on two arguments.…”

Section: Discussionmentioning

confidence: 80%

“…One can argue that 10 µg ITS was insufficient in our study, but the combination of 50 µg ITS and 0.5 mg ITM were not superior to ITM alone in thoracic surgery, even though this study was probably underpowered (ten patients per group). 3 Again, it is possible that a ceiling effect similar to the one observed in volunteers 22 or in the obstetrical setting 21 may also exist for ITS. A properly powered dose-response study investigating ITS combinations to ITM in colorectal surgery could answer this question.…”

Section: Discussionmentioning

confidence: 97%

“…Drawing from a previous study which showed a 23% reduction in intraoperative intravenous sufentanil consumption, 3 we estimated that 34 patients per group would be required to detect a significant difference with an α risk set at 5% and a β risk at 20%. Allowing for attrition, we recruited 40 patients per group.…”

Section: Methodsmentioning

confidence: 99%

“…16 Combining ITS and ITM may provide the optimal analgesic regimen to cover the intraoperative, the immediate, and the delayed postoperative periods up to 24 hr. 3 This combination of IT opiods has been studied in cardiac, 2,17 abdominal aortic 18 and thoracic 3,19 surgery to shorten the onset of morphine and to reduce ITM dose. However, the doses of ITS used in these studies were relatively high (25-50 µg) to achieve adequate pain relief.…”

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confidence: 99%

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Low-dose sufentanil dœs not potentiate intra-thecal morphine for perioperative analgesia after major colorectal surgery

et al. 2007

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Purpose: Both intrathecal sufentanil (ITS) and intrathecal morphine (ITM) improve analgesia in obstetrical or cardiac procedures. From a pharmacokinetic standpoint, combining these two opioids may improve perioperative analgesia. We performed a prospective randomized double-blind study to compare the analgesic efficacy of ITM alone vs a mixture of a low dose of ITS plus ITM for perioperative pain relief in colorectal surgery. Methods:Eighty adult patients undergoing colorectal surgery were randomly allocated to receive either 0.4 mg ITM alone or 10 µg ITS plus 0.4 mg ITM before general anesthesia. Intraoperative intravenous sufentanil consumption, postoperative morphine consumption delivered with a patient controlled analgesia device, pain scores, patient satisfaction and adverse effects were recorded for the first 48 hr postoperatively. Results:No differences were observed between groups with respect to intraoperative sufentanil consumption (39 ± 23 µg in group ITM and 40 ± 25 µg in group ITS plus ITM, P = 0.85) and in postoperative morphine consumption in postanesthesia care unit (6 ± 5 mg vs 6 ± 5 mg, P = 0.59), at 24 hr (26 ± 17 vs 24 ± 15 mg, P = 0.59) and at 48 hr (47 ± 31 vs 44 ± 22 mg, P = 0.58). Similarly, no differences were observed in regards to pain relief, patient satisfaction and incidence of adverse effects. Conclusions:These results do not support the addition of 10 µg ITS to 0.4 mg ITM for colorectal surgery, as low dose sufentanil does not improve intraoperative and postoperative analgesia in this setting. post-anesthésiques (6 ± 5 mg vs 6 ± 5 mg, P = 0,59), à 24 h (26 ± 17 vs 24 ± 15 mg, P = 0,59) et à 48 h (47 ± 31 vs 44 ± 22 mg, P = 0,58

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Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 97%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

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Low-dose sufentanil dœs not potentiate intra-thecal morphine for perioperative analgesia after major colorectal surgery

et al. 2007

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“…La [17][18][19] Dans cette étude, les concentrations de bupivacaïne et de fentanyl utilisées pour la péridurale sont celles recommandées dans la littérature : la bupivacaïne à 0,1 % associée au fentanyl 2 µg·mL -1 . Pour la rachianalgésie les doses de morphine intrathécale recommandées varient selon le site opératoire : 0,1 à 0,3 mg pour les interventions sous-ombilicales, 0,3 mg pour les interventions sus-ombilicales et 0,5 mg pour les interventions portant sur le thorax.…”

Section: Fonction Respiratoireunclassified

L’analgésie péridurale thoracique et rachidienne ont des effets comparables sur la douleur et la fonction respiratoire après chirurgie thoracique

Madi-Jebara¹,

Adaimé²,

Yazigi³

et al. 2005

Can J Anesth/J Can Anesth

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O Ob bj je ec ct ti if f : : Comparer l'effet de la rachianalgésie à la morphine (M) et au sufentanil (S) à la péridurale thoracique sur l'analgésie et la fonction respiratoire après chirurgie thoracique.M Ma at té ér ri ie el l e et t m mé ét th ho od de es s : : Quarante-cinq patients de 58,4 ± 13 ans d'âge moyen subissant une thoracotomie postéro-latérale ont été divisés en deux groupes. Les patients du Groupe I (n = 27) ont reçu une rachianalgésie lombaire (5 µg de S et 0,5 mg de M) une heure avant l'induction. Groupe II (n = 28) a reçu après l'induction, 10 à 20 mL d'une solution de bupivacaine (B) 0.25 % et fentanyl (F) 2 µg·mL -1 à travers un cathéter péridural installé entre T5 et T8 avant l'induction. Une perfusion continue de cette solution a été administrée en période peropératoire. Après chirurgie et pendant 48 h, une perfusion de B 0.1 % et F 2 µg·mL -1 a été administrée avec des bolus toutes les 15 min si nécessaire. Les variables étudiées sont : la fréquence cardiaque (FC), la pression artérielle moyenne (PAM), la saturation périphérique en O 2 (SpO 2 ), la fréquence respiratoire (FR), la pression artérielle en O 2 (PaCO 2 ), le volume expiratoire maximal à la première seconde, la capacité vitale fonctionnelle, le débit expiratoire maximal et l'échelle visuelle analogique (EVA) de la douleur au repos et au mouvement et ceci à différents temps allant de la veille de la chirurgie à T48 = 48 h après chirurgie.R Ré és su ul lt ta at ts s : : L'EVA au repos et au mouvement, la FC, la PAM, la SpO 2 , la PaCO 2 , la FR et les variations des tests pulmonaires sont comparables dans les deux groupes.C Co on nc cl lu us si io on n : : La rachianalgésie à la M et au S a des effets comparables à la péridurale thoracique à la B et au F sur l'analgésie et la fonction respiratoire après chirurgie thoracique. Purpose: To compare in a prospective randomized trial the effects of thoracic epidural infusions of fentanyl (F) and bupivacaine (B) to intrathecal morphine (M) and sufentanil (S) on analgesia and respiratory function following thoracotomy.

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Pain Management After Thoracic Surgery

Pennefather

McKevith

2011

Principles and Practice of Anesthesia for Thoracic Surgery

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A Randomized, Double-Blinded Comparison of Intrathecal Morphine, Sufentanil and their Combination versus IV Morphine Patient-Controlled Analgesia for Postthoracotomy Pain

Cited by 65 publications

References 18 publications

Low-dose sufentanil dœs not potentiate intra-thecal morphine for perioperative analgesia after major colorectal surgery

Low-dose sufentanil dœs not potentiate intra-thecal morphine for perioperative analgesia after major colorectal surgery

L’analgésie péridurale thoracique et rachidienne ont des effets comparables sur la douleur et la fonction respiratoire après chirurgie thoracique

Pain Management After Thoracic Surgery

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