Postoperative ache scores and opioid consumption in opioid-dependent sufferers with most cancers after intraoperative remifentanil analgesia: A potential case-controlled research.
J Opioid Manag. 2017 Jul/Aug;13(Four):221-228
Authors: Motamed C, Audibert J, Albi-Feldzer A, Bouroche G, Jayr C
BACKGROUND: Opioid dependency is changing into more and more frequent amongst surgical sufferers with most cancers, and may result in insufficient ache reduction throughout the preliminary postoperative interval. No pointers are at present accessible for the administration of perioperative and postoperative morphine administration in these sufferers. As a primary method, the authors assessed the opioid necessities of those sufferers throughout the early postoperative interval.
METHODS: A gaggle of 35 consecutive surgical sufferers with most cancers on opioid remedy (opioid-dependent group) for most cancers ache have been in comparison with a matched group of 44 surgical opioid-naive sufferers (management group). All sufferers underwent main head and neck or belly surgical procedure. The next parameters have been recorded and in contrast: preoperative and postoperative morphine consumption, patient-controlled analgesia data and Visible Analog Scale scores, intraoperative remifentanil and desflurane consumption, Bispectral Index monitoring values, coronary heart fee, and blood stress.
RESULTS: Remifentanil necessities have been considerably larger (1.Four-fold) within the opioid-dependent group in comparison with the management group (p < zero.05). On postoperative day 1, morphine necessities have been considerably larger within the opioid-dependent group (2.Three-fold) in comparison with the management group (p < zero.05). Baseline coronary heart fee was considerably larger within the opioid-dependent group and this distinction remained important throughout surgical procedure, no important distinction in blood stress was noticed between the 2 teams.
CONCLUSION: This research exhibits a 40 % enhance of intraoperative remifentanil necessities in opioid-dependent sufferers throughout most cancers surgical procedure. Morphine necessities throughout the postoperative interval have been elevated by as much as 140 %.
PMID: 28953314 [PubMed – indexed for MEDLINE]