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
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.