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Effects of Intraoperative Opioid Administration on Postoperative Pain and Pain Threshold: A Randomized Controlled Study

Fentanyl and short-acting remifentanil are often used in combination. We evaluated the effect of intraoperative opioid administration on postoperative pain and pain thresholds when the two drugs were used. Patients who underwent gynecological laparoscopic surgery were randomly assigned into two grou...

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Autores principales: Kawanaka, Ryoko, Sakuma, Shoko, Kokubun, Hiroshi, Tetsu, Shuhei, Tagaito, Yugo, Igarashi, Toshio, Liang, Shan-Guang, Aoe, Tomohiko
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9572642/
https://www.ncbi.nlm.nih.gov/pubmed/36233454
http://dx.doi.org/10.3390/jcm11195587
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author Kawanaka, Ryoko
Sakuma, Shoko
Kokubun, Hiroshi
Tetsu, Shuhei
Tagaito, Yugo
Igarashi, Toshio
Liang, Shan-Guang
Aoe, Tomohiko
author_facet Kawanaka, Ryoko
Sakuma, Shoko
Kokubun, Hiroshi
Tetsu, Shuhei
Tagaito, Yugo
Igarashi, Toshio
Liang, Shan-Guang
Aoe, Tomohiko
author_sort Kawanaka, Ryoko
collection PubMed
description Fentanyl and short-acting remifentanil are often used in combination. We evaluated the effect of intraoperative opioid administration on postoperative pain and pain thresholds when the two drugs were used. Patients who underwent gynecological laparoscopic surgery were randomly assigned into two groups (15 patients each) to receive either sufficient (group A) or minimum (group B) fentanyl (maximum estimated effect site concentration: A: 7.86 ng/mL, B: 1.5 ng/mL). The estimated effect site concentration at the end of surgery was adjusted to the same level (1 ng/mL). Patients in both groups also received continuous intravenous remifentanil during surgery. The primary outcome was the pressure pain threshold, as evaluated by a pressure algometer 3 h postoperatively. The pressure pain threshold at 3 h postoperatively was 51.1% (95% CI: [44.4–57.8]) in group A and 56.6% [49.5–63.6] in group B, assuming a preoperative value of 100% (p = 0.298). There were no significant differences in pressure pain threshold and numeric rating scale scores between the groups after surgery. The pain threshold decreased significantly in both groups at 3 h postoperatively compared to preoperative values, and recovered at 24 h. Co-administration of both opioids caused hyperalgesia regardless of fentanyl dose.
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spelling pubmed-95726422022-10-17 Effects of Intraoperative Opioid Administration on Postoperative Pain and Pain Threshold: A Randomized Controlled Study Kawanaka, Ryoko Sakuma, Shoko Kokubun, Hiroshi Tetsu, Shuhei Tagaito, Yugo Igarashi, Toshio Liang, Shan-Guang Aoe, Tomohiko J Clin Med Article Fentanyl and short-acting remifentanil are often used in combination. We evaluated the effect of intraoperative opioid administration on postoperative pain and pain thresholds when the two drugs were used. Patients who underwent gynecological laparoscopic surgery were randomly assigned into two groups (15 patients each) to receive either sufficient (group A) or minimum (group B) fentanyl (maximum estimated effect site concentration: A: 7.86 ng/mL, B: 1.5 ng/mL). The estimated effect site concentration at the end of surgery was adjusted to the same level (1 ng/mL). Patients in both groups also received continuous intravenous remifentanil during surgery. The primary outcome was the pressure pain threshold, as evaluated by a pressure algometer 3 h postoperatively. The pressure pain threshold at 3 h postoperatively was 51.1% (95% CI: [44.4–57.8]) in group A and 56.6% [49.5–63.6] in group B, assuming a preoperative value of 100% (p = 0.298). There were no significant differences in pressure pain threshold and numeric rating scale scores between the groups after surgery. The pain threshold decreased significantly in both groups at 3 h postoperatively compared to preoperative values, and recovered at 24 h. Co-administration of both opioids caused hyperalgesia regardless of fentanyl dose. MDPI 2022-09-23 /pmc/articles/PMC9572642/ /pubmed/36233454 http://dx.doi.org/10.3390/jcm11195587 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Kawanaka, Ryoko
Sakuma, Shoko
Kokubun, Hiroshi
Tetsu, Shuhei
Tagaito, Yugo
Igarashi, Toshio
Liang, Shan-Guang
Aoe, Tomohiko
Effects of Intraoperative Opioid Administration on Postoperative Pain and Pain Threshold: A Randomized Controlled Study
title Effects of Intraoperative Opioid Administration on Postoperative Pain and Pain Threshold: A Randomized Controlled Study
title_full Effects of Intraoperative Opioid Administration on Postoperative Pain and Pain Threshold: A Randomized Controlled Study
title_fullStr Effects of Intraoperative Opioid Administration on Postoperative Pain and Pain Threshold: A Randomized Controlled Study
title_full_unstemmed Effects of Intraoperative Opioid Administration on Postoperative Pain and Pain Threshold: A Randomized Controlled Study
title_short Effects of Intraoperative Opioid Administration on Postoperative Pain and Pain Threshold: A Randomized Controlled Study
title_sort effects of intraoperative opioid administration on postoperative pain and pain threshold: a randomized controlled study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9572642/
https://www.ncbi.nlm.nih.gov/pubmed/36233454
http://dx.doi.org/10.3390/jcm11195587
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