EVALUATION OF PAIN FOLLOWING ELECTROCAUTERY TUBAL-LIGATION AND EFFECTOF INTRAOPERATIVE FENTANYL

Study Objective. To evaluate pain following laparoscopic tubal sterili zation (LTS) and the effects of supplemental in intraoperative fentany l. Design: Open evaluation of pain intensity and opioid requirements w ith double-blind, randomized evaluation of intraoperative fentanyl. Se tting: Outpatient centre of a university-affiliated teaching hospital. Patients: 44 ASA status I patients who underwent LTS by electrocauter y. Interventions: Patients received either intravenous fentanyl (F) 1 mu g/kg or saline (S) at induction. Measurements and Main Results: Pai n intensity was measured with patient assessments of visual analog sca les (VAS) and cumulative opioid requirements. The group that received intraoperative fentanyl received 70.2 +/- 3.7 mu g at induction. VAS o n postanesthesia care unit arrival was 4.9 +/- 0.5 (F) and 5.9 +/- 0.5 (S) (means +/- SEM). VAS after one hour was 2.1 +/- 0.2 in both group s. During that hour, the F group consumed 107.5 +/- 14.7 mu g and the S group consumed 140.5 +/- 15.7 mu g fentanyl. The range of fentanyl c onsumed by each group in the postoperative period was 0 to 250 mu g. T here were no statistically significant differences between the F and S groups. Conclusions: Pain following LTS by electrocautery is of signi ficant magnitude and may require relatively large doses of opioids for adequate management. Supplemental intraoperative fentanyl 1 mu/kg did not produce a clinically significant reduction in either pain scores or opioid requirements.