A comparison of intrathecal analgesia with fentanyl or sufentanil after total hip replacement

We designed this study to compare the postoperative analgesic effects of in trathecal fentanyl and sufentanil, the end points being onset, quality, and duration of action. A total of 42 geriatric patients, scheduled for electi ve total hip replacement under continuous spinal anesthesia, were randomize d in two double-blinded groups as soon as they experienced a pain score hig her than 3 of 10 on the visual analog scale in the recovery room. Either 7. 5 mu g sufentanil or 30 mu g fentanyl in 2 mL normal saline were intratheca lly administered. Pain scores, rescue analgesia (ketorolac and morphine), a nd adverse effects (respiratory depression, postoperative nausea and vomiti ng, and itching) were recorded for 24 h after surgery. In both groups, comp aring sufentanil to fentanyl, the time to a pain score <3 (9 +/- 9 vs 11 +/ - 8 min), the time to the lowest pain score (18 +/- 6 vs 20 +/- 15 min), an d the time to the first systemic analgesic intervention for a pain score >3 (241 +/- 102 vs 214 +/- 120 min) were comparable as were the analgesic req uirements during the first 24 h. We conclude that, after total hip replacem ent, both lipid soluble opioids produce excellent analgesia with comparable onset, duration of action, and low incidence of minor adverse effects. Imp lications: We compared the postoperative analgesic properties of 40 mu g in trathecal fentanyl and 7.5 mu g sufentanil after total hip replacement. Bot h opioids provided satisfactory analgesia, with comparable onset (11 +/- 8 vs 9 +/- 9 min) and duration of action (214 +/- 120 vs 241 + 102 min), as w ell as low incidence of minor side effects.