Comparative Study of Epidural and Intravenous Fentanyl for Postoperative Analgesia of Orthopedic Surgeries

摘要

There are controversies about the action site of lipophylic opioids after epidural injection. Some authors believe that these drugs act at supraspinal level, while others propose a spinal action. This comparative study aimed at answering this question by comparing epidural and intravenous fentanyl for postoperative analgesia of lower limb orthopedic procedures.At postoperative pain complaint, G1 patients (n = 14) received 5 mL epidural solution (100 mug fentanyl in 0.9% saline) and 2 ml. of intravenous 0.9% saline; G2 patients (n = 15) received 5 mL epidural 0.9% saline and 2 mL intravenous fentanyl (100 mug). Analgesic complementation with intravenous tenoxicam (40 mg) and epidural 0.25% bupivacaine (5 mL) (when there was no relief with tenoxicam) has been evaluated. Number of patients needing analgesic complementation both with tenoxicam (G1 =10 and G2 = 15 patients) and bupivacaine (G1 = 2 and G2 = 8 patients) has been higher in G2. There have been no statistical differences in pain intensity between groups in all studied moments. In conclusion, effects of epidural fentanyl were better as compared to intravenous fentanyl.