Comparison of Sufentanil- and Fentanyl-based Intravenous Patient-controlled Analgesia on Postoperative Nausea and Vomiting after Laparoscopic Nephrectomy: A Prospective, Double-blind, Randomized-controlled Trial

Lee, Hye-Mi; Kil, Hae Keum; Koo, Bon‐Nyeo; Song, Min; Park, Jin Ha

doi:10.7150/ijms.39374

Cited by 16 publications

(10 citation statements)

References 36 publications

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“… 34 , 35 IL-12 is a key cytokine in mediating cellular immunity, especially in inducing Th1 differentiation both in vivo and in vitro. 25 , 27 In contrast to IL-12, IL-10 is a suppressive factor acting on antigen-presenting cells to inhibit cytokine secretion by Th1 cells. 48 , 55 Second, studies have shown that tramadol, as a weak agonist of μ receptors, can reduce the differentiation of Th cells into Th2 types.…”

Section: Discussionmentioning

confidence: 99%

“… 26 It was also found that, with the same analgesic effect, sufentanil had a stronger effect than fentanyl on the increase of Treg cells in vitro. 27 Moreover, sufentanil may decrease the CD4 + /CD8 + ratio and increase the frequency of Treg cells. 28 , 29 Treg cells in the breast cancer were positively associated with disease progression, and the CD8+/Treg ratio was associated with lymph node metastasis and tumor staging.…”

Section: Introductionmentioning

confidence: 99%

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Effects of Dezocine and Sufentanil on Th1/Th2 Balance in Breast Cancer Patients Undergoing Surgery

Hu¹,

Liu²,

Wu³

et al. 2021

DDDT

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Background: It is very important for breast cancer patients undergoing surgery to choose an opioid that has little effect on the immune system. The aim of this study is to compare the effects of dezocine or sufentanil on postoperative pain and Th1/Th2 balance in patients undergoing breast cancer surgery. Methods: Data from 92 breast cancer patients from January 2019 to July 2020 at Foshan Second People's Hospital (Guangdong, China) were analyzed. Sufentanil (SF) was used in group SF (n = 44) and dezocine (DE) in group DE (n = 48). The Visual Analog Scale (VAS) scores were assessed, and the percentages of Th1 cells and Th2 cells in peripheral blood were detected before anesthesia and at 2, 12, 24, and 48 hours after surgery. Results: There was no significant difference in the VAS scores between the two groups at 2, 24, and 48 hours after surgery (P > 0.05). The VAS scores at 12 hours after surgery in group DE were significantly lower than those in group SF with a statistically significant difference (P < 0.05). The percentage of Th1 cells in group DE at 2, 12, 24, and 48 hours after surgery was significantly lower than that in group SF (P < 0.05). The percentage of Th2 cells in group DE at 2, 12, 24, and 48 hours after surgery was significantly lower than that in group SF (P < 0.05). The Th1/Th2 ratio at 2, 12, 24, and 48 hours after surgery was significantly higher in group DE than that in group SF (P < 0.05). Conclusion: Dezocine for anesthesia induction and postoperative analgesia can maintain the balance of Th1/Th2 more stable than, with the same analgesia efficacy as, sufentanil during the early postoperative period in breast cancer patients undergoing surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effects of Dezocine and Sufentanil on Th1/Th2 Balance in Breast Cancer Patients Undergoing Surgery

Hu¹,

Liu²,

Wu³

et al. 2021

DDDT

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“…This could be explained as follows: sufentanil has an 8–10 times higher lipid solubility than fentanyl, a higher affinity for the mu-opioid receptor, and 5–10 times more potency than fentanyl; thus, smaller doses are required to achieve an analgesic and sedative effect. 12 Monk et al also confirmed that unlike other opioids, sufentanil alone induces significantly less cardiovascular instability. It may cause a reduction in HR and BP shortly after the induction of anesthesia, but the cardiovascular instability usually associated with surgery is largely avoided.…”

Section: Discussionmentioning

confidence: 90%

“… 11 Sufentanil is more potent than fentanyl and is the most effective opioid analgesic used in clinical practice. 12 , 13 Previous studies have shown that sufentanil might be beneficial over fentanyl by relieving pain and reducing the incidence of opioid-related adverse events. 14 , 15 However, these studies were mostly performed in adults.…”

Section: Introductionmentioning

confidence: 99%

Comparison of the Effects of Sufentanil and Fentanyl on Postoperative Sleep Quality of Children Undergoing Tonsillectomy and Adenotomy: A Randomized Controlled Trial

Li¹,

Song²,

Li³

et al. 2021

NSS

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Objective The primary purpose was to compare the effects of sufentanil and fentanyl on the postoperative sleep quality. And the secondary purposes were to evaluate perioperative hemodynamics, postoperative pain and complications of children undergoing tonsillectomy and adenotomy. Methods Seventy-six patients were randomly assigned to the sufentanil or fentanyl group. The subjective sleep quality was assessed by the Athens Insomnia Scale (AIS) on the night before surgery (Sleep preop 1), the first night after surgery (Sleep POD 1), and the third night after surgery (Sleep POD 3). The Faces Pain Scale-Revised (FPS-R) was used to evaluate the postoperative pain level 24 hours after surgery. The Observer’s Assessment of Alertness and Sedation (OAA/S) scale was used to assess the level of sedation in children. Perioperative hemodynamics and adverse effects were also evaluated. Results The AIS score in the sufentanil group was significantly lower at Sleep POD 1 and Sleep POD 3 (P < 0.001, respectively). Children in the sufentanil group had significantly lower FPS-R scores at 2, 4, and 6 hours after surgery (P = 0.004, P = 0.004, and P = 0.001, respectively). The intraoperative hemodynamic parameters were more stable (P < 0.05, respectively) and the OAA/S scores at 2 hours after surgery were lower in the sufentanil group (P < 0.05). There was no significant difference in the incidence of postoperative nausea and vomiting between the two groups (P = 0.435). Conclusion Children undergoing tonsillectomy and adenotomy after general anesthesia who received sufentanil had better postoperative sleep quality and less postoperative pain at 2, 4, and 6 hours post operation. Moreover, children who received sufentanil showed better hemodynamic stability during surgery. Therefore, sufentanil should be considered as a better choice to facilitate rapid recovery in children following tonsillectomy and adenotomy.

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“…The incidence of PONV is up to 70%-80% in high-risk groups, including female patients who undergo laparoscopy, prolonged operation duration and anesthetic medication, etc. PONV has been recognized to be related to the application of sufentanil (Lee et al, 2020;Massoth et al, 2021). Therefore, it is essential for an anesthesiologist to minimize sufentanil-related PONV.…”

Section: Introductionmentioning

confidence: 99%

Low-dose naloxone for prophylaxis of sufentanil-induced choking and postoperative nausea and vomiting

et al. 2022

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Sufentanil, a potent opioid, serves as the first option for perioperative analgesia owing to its analgesic effect, long duration and stable hemodynamics, whereas its side effects frequently blunt its application. The intravenous (IV) injection of sufentanil during anesthesia induction has high incidence of choking or bucking reaction, which is defined as sufentanil-induced cough (SIC). Moreover, postoperative nausea and vomiting (PONV) is a common and stressful complication, which is also related to the usage of opioid. High incidence of PONV is reported in the patients with SIC. Hence, we sought to determine whether naloxone, an opioid antagonist, at low dose would decrease the incidences of SIC and PONV. 216 female patients undergoing gynecological laparoscopic operation (<2 h) under general anesthesia were recruited in this study, and randomly assigned into two groups: Group N (patients receiving naloxone and Group C (patients receiving vehicle). Sufentanil (0.5 μg/kg within 5 s) was given in anesthesia induction, and low-dose naloxone (1.25 μg/kg) or identical vehicle was initially injected 5 min prior to induction, with the incidence and severity of SIC estimated. Subsequently, naloxone or vehicle was continuously infused at the rate of 0.5 μg/kg/h in the initiation of operation until the end of the operation, and the transverse abdominal fascia block (TAP) was performed for postoperative analgesia. The PONV profiles such as incidence and the severity, grading, and the frequencies of antiemetic usage within 24 h were evaluated, with VAS scores and remedial measures for analgesia during the first 24 h postoperatively were recorded. Our results revealed that one bolus of low-dose naloxone prior to the induction significantly mitigated the incidence of SIC, and intraoperative continuous infusion of low-dose naloxone reduced the incidence and the severity of PONV, so that the postoperative VAS scores and further remedial analgesia were not altered. These results not only provide clinical solutions for prophylaxis of SIC and PONV, but also suggests that opioids may act as a key role in both SIC and PONV, whereas opioid antagonist may hit two tasks with one stone. Moreover, further investigations are required to address the underlying mechanism of SIC and PONV.Clinical Trial Registration: [www.chictr.org.cn], identifier [ChiCTR2200064865].

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Comparison of Sufentanil- and Fentanyl-based Intravenous Patient-controlled Analgesia on Postoperative Nausea and Vomiting after Laparoscopic Nephrectomy: A Prospective, Double-blind, Randomized-controlled Trial

Cited by 16 publications

References 36 publications

Effects of Dezocine and Sufentanil on Th1/Th2 Balance in Breast Cancer Patients Undergoing Surgery

Effects of Dezocine and Sufentanil on Th1/Th2 Balance in Breast Cancer Patients Undergoing Surgery

Comparison of the Effects of Sufentanil and Fentanyl on Postoperative Sleep Quality of Children Undergoing Tonsillectomy and Adenotomy: A Randomized Controlled Trial

Low-dose naloxone for prophylaxis of sufentanil-induced choking and postoperative nausea and vomiting

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