Comparison of post operative analgesia with Fentanyl and Sulfentanil via epidural route in thoracic and upper abdominal surgeries

Abstract

Background: Post-operative analgesia has been considered very important for patient in terms of early mobilization and prevention of complications. Opioid analgesics have long been recognized as among the most effective treatments for pain. Opioids like fentanyl and sufentanil have been successfully used for post-operative analgesia by epidural route. Aims & Objective: To evaluate the efficacy of Sufentanil and Fentanyl for post-operative analgesia following thoracic and upper abdominal surgeries through epidural route. Materials and Methods: This was a prospective randomized parallel group study of 60 patients. They were divided into two groups randomly, F and SF. They were given fentanyl and sufentanil by epidural route for post-operative pain relief following upper abdominal and Thoracic surgery. Pain was assessed through Visual analogue scale. Pain Relief assessment, Pulse rate, BP, Respiratory rate, SPO2, Sedation Score and complication if any were assessed after administration of drug at 0,2,5,10,30,60,,120, 240 and 300 minutes. Result obtained were statistically analysed using students unpaired t test after calculating mean and standard deviation. Results: Patients in both group were comparable in terms of demography with male predominance, ASA grade and type of surgery performed. Onset of pain relief was 7.22 ± 1.82 minutes with fentanyl while 3.40±0.90 with sufentanil. Peak analgesic effect was achieved at 20.36 ± 3.44 minutes with fentanyl while it was quicker with sufentanil (9.3±2.4). Duration of analgesia was higher in sufentanil group (254.1 ± 53.80) in comparison to fentanyl (185.2 ± 43.33). Conclusion: Sufentanil via epidural route provides early onset, peak effect and longer duration of effective analgesia in comparison to Fentanyl. Use of either drug via epidural route provide safety and better stabilization as far as the hemodynamic and respiratory parameters were concerned. But, Patients with sufentanil remained sedated for longer duration than fentanyl.