Cargando…

Conscious Sedation for Balloon Mitral Valvotomy: A Comparison of Fentanyl versus Sufentanil

CONTEXT: Analgesia and sedation are required for the comfort of patient and the cardiologist during balloon mitral valvotomy. AIMS: In this study, efficacy of analgesia, sedation, and patient satisfaction with sufentanil was compared with fentanyl. SETTINGS AND DESIGN: Single-centered, prospective s...

Descripción completa

Detalles Bibliográficos
Autores principales: Modak, Shailendra Deochandra, Kane, Deepa G
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5408520/
https://www.ncbi.nlm.nih.gov/pubmed/28393775
http://dx.doi.org/10.4103/0971-9784.203930
_version_ 1783232324275535872
author Modak, Shailendra Deochandra
Kane, Deepa G
author_facet Modak, Shailendra Deochandra
Kane, Deepa G
author_sort Modak, Shailendra Deochandra
collection PubMed
description CONTEXT: Analgesia and sedation are required for the comfort of patient and the cardiologist during balloon mitral valvotomy. AIMS: In this study, efficacy of analgesia, sedation, and patient satisfaction with sufentanil was compared with fentanyl. SETTINGS AND DESIGN: Single-centered, prospective single-blind study of sixty patients. MATERIALS AND METHODS: Patients between 15 and 45 years of rheumatic mitral stenosis with valve area of 0.8–1 cm(2) undergoing elective balloon mitral valvotomy, randomly divided to receive bolus injection fentanyl 1 mcg/kg (Group 1, n = 30) followed by infusion at 1 mcg/kg/h or bolus of injection sufentanil 0.1 mcg/kg (Group 2, n = 30) followed by continuous infusion at 0.1 mcg/h. Both the groups received injection midazolam bolus 0.02 mg/kg followed by infusion at 15 mcg/kg/h. Pain intensity (by visual analog score [VAS]), level of sedation (by Ramsay sedation scale), overall patient and operator's satisfaction, effect on cardiorespiratory parameters, and discharge score (by modified Aldrete score) were assessed. STATISTICAL ANALYSIS USED: Statistical analysis used Student's unpaired t-test and Chi-square test. P < 0.05 was considered statistically significant. RESULTS: Mean number of bolus doses in fentanyl group was 0.9 versus 0.13 in sufentanil group (P < 0.01). The mean value of mean blood pressure in fentanyl group was 83.52 mmHg versus 88 mmHg in sufentanil group (P < 0.05), but the value was within normal range in both the groups. The mean VAS – patient's opinion in fentanyl group was 8.97 versus 9.53 in sufentanil group (P < 0.05). Mean discharge score in fentanyl group was 17.87 versus 18.23 in sufentanil group (P < 0.05). No statistically significant difference was found with respect to heart rate, respiratory rate, oxygen saturation, PaCO(2) values, and anxiety scores. CONCLUSION: Sufentanil was found to be better with respect to analgesia, patient satisfaction, and recovery however not cost-effective for continuous infusion technique.
format Online
Article
Text
id pubmed-5408520
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher Medknow Publications & Media Pvt Ltd
record_format MEDLINE/PubMed
spelling pubmed-54085202017-05-08 Conscious Sedation for Balloon Mitral Valvotomy: A Comparison of Fentanyl versus Sufentanil Modak, Shailendra Deochandra Kane, Deepa G Ann Card Anaesth Original Article CONTEXT: Analgesia and sedation are required for the comfort of patient and the cardiologist during balloon mitral valvotomy. AIMS: In this study, efficacy of analgesia, sedation, and patient satisfaction with sufentanil was compared with fentanyl. SETTINGS AND DESIGN: Single-centered, prospective single-blind study of sixty patients. MATERIALS AND METHODS: Patients between 15 and 45 years of rheumatic mitral stenosis with valve area of 0.8–1 cm(2) undergoing elective balloon mitral valvotomy, randomly divided to receive bolus injection fentanyl 1 mcg/kg (Group 1, n = 30) followed by infusion at 1 mcg/kg/h or bolus of injection sufentanil 0.1 mcg/kg (Group 2, n = 30) followed by continuous infusion at 0.1 mcg/h. Both the groups received injection midazolam bolus 0.02 mg/kg followed by infusion at 15 mcg/kg/h. Pain intensity (by visual analog score [VAS]), level of sedation (by Ramsay sedation scale), overall patient and operator's satisfaction, effect on cardiorespiratory parameters, and discharge score (by modified Aldrete score) were assessed. STATISTICAL ANALYSIS USED: Statistical analysis used Student's unpaired t-test and Chi-square test. P < 0.05 was considered statistically significant. RESULTS: Mean number of bolus doses in fentanyl group was 0.9 versus 0.13 in sufentanil group (P < 0.01). The mean value of mean blood pressure in fentanyl group was 83.52 mmHg versus 88 mmHg in sufentanil group (P < 0.05), but the value was within normal range in both the groups. The mean VAS – patient's opinion in fentanyl group was 8.97 versus 9.53 in sufentanil group (P < 0.05). Mean discharge score in fentanyl group was 17.87 versus 18.23 in sufentanil group (P < 0.05). No statistically significant difference was found with respect to heart rate, respiratory rate, oxygen saturation, PaCO(2) values, and anxiety scores. CONCLUSION: Sufentanil was found to be better with respect to analgesia, patient satisfaction, and recovery however not cost-effective for continuous infusion technique. Medknow Publications & Media Pvt Ltd 2017 /pmc/articles/PMC5408520/ /pubmed/28393775 http://dx.doi.org/10.4103/0971-9784.203930 Text en Copyright: © 2017 Annals of Cardiac Anaesthesia http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Original Article
Modak, Shailendra Deochandra
Kane, Deepa G
Conscious Sedation for Balloon Mitral Valvotomy: A Comparison of Fentanyl versus Sufentanil
title Conscious Sedation for Balloon Mitral Valvotomy: A Comparison of Fentanyl versus Sufentanil
title_full Conscious Sedation for Balloon Mitral Valvotomy: A Comparison of Fentanyl versus Sufentanil
title_fullStr Conscious Sedation for Balloon Mitral Valvotomy: A Comparison of Fentanyl versus Sufentanil
title_full_unstemmed Conscious Sedation for Balloon Mitral Valvotomy: A Comparison of Fentanyl versus Sufentanil
title_short Conscious Sedation for Balloon Mitral Valvotomy: A Comparison of Fentanyl versus Sufentanil
title_sort conscious sedation for balloon mitral valvotomy: a comparison of fentanyl versus sufentanil
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5408520/
https://www.ncbi.nlm.nih.gov/pubmed/28393775
http://dx.doi.org/10.4103/0971-9784.203930
work_keys_str_mv AT modakshailendradeochandra conscioussedationforballoonmitralvalvotomyacomparisonoffentanylversussufentanil
AT kanedeepag conscioussedationforballoonmitralvalvotomyacomparisonoffentanylversussufentanil