A COMPARISON OF PENTAMORPHONE AND FENTANYL IN BALANCED ANESTHESIA DURING GENERAL-SURGERY

Citation
Wb. Kelly et al., A COMPARISON OF PENTAMORPHONE AND FENTANYL IN BALANCED ANESTHESIA DURING GENERAL-SURGERY, Canadian journal of anaesthesia, 41(8), 1994, pp. 703-709
Citations number
11
Categorie Soggetti
Anesthesiology
ISSN journal
0832610X
Volume
41
Issue
8
Year of publication
1994
Pages
703 - 709
Database
ISI
SICI code
0832-610X(1994)41:8<703:ACOPAF>2.0.ZU;2-X
Abstract
The purpose of our randomized, double-blind study of 64 unpremedicated healthy patients undergoing surgical procedures with a duration of at least 60 min was to compare 0.75 mu g.kg(-1) and 1 mu g.kg(-1) pentam orphone with 5 mu g.kg(-1) and 7.5 mu g.kg(-1) fentanyl to determine w hich dose of opioid would reduce the requirement for isoflurane supple mentation needed to maintain haemodynamic stability. At 21 points duri ng the procedure, the haemodynamic variables of heart rate and systoli c, diastolic, and mean arterial pressures were recorded. The use of is oflurane was quantified; the number of patients requiring inhaled anae sthetic, concentration peaks, MAC minutes, and duration of isoflurane use were noted. The number of equal-volume supplemental opioid analges ic doses, post-operative analgesics, occurrence of postoperative nause a, emesis, and antiemetic doses were compared. The four groups exhibit ed similar patient demographics, total dose of muscle relaxants, types of surgical procedures, and duration of surgery or anaesthesia Haemod ynamic variables were stable with no difference among the four study g roups. The patients given pentamorphone demonstrated both delayed requ irement (P < 0.05) and shorter duration (P < 0.05) of isoflurane suppl ementation. Patients given either 5 mu g.kg(-1) or 7.5 mu g.kg(-1) fen tanyl needed isoflurane supplementation within 12 +/- 16 min and 12 +/ - 17 min from induction respectively; while patients given either 0.75 mu g.kg(-1) or 1 mu g.kg(-1) pentamorphone did not require isoflurane supplementation for 37 +/- 10 min and 43 +/- 26 min respectively. In addition, the 1 mu g.kg(-1) pentamorphone group had significantly (P < 0.05) lower peak isoflurane concentrations than the 5 mu g.kg(-1) fen tanyl study group (0.9 +/- 0.5 MAC% vs 1.5 +/- 0.3 MAC%). In conclusio n, we found pentamorphone to be a haemodynamically stable, isofluranes paring opioid analgesic. Pentamorphone's major advantage over fentanyl was its lower requirement for inhalation agent in a balanced anaesthe sia technique.