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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| Format: | Article |
| Language: | English |
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MDPI AG
2022-09-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/19/5587 |
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| author | Ryoko Kawanaka Shoko Sakuma Hiroshi Kokubun Shuhei Tetsu Yugo Tagaito Toshio Igarashi Shan-Guang Liang Tomohiko Aoe |
| author_facet | Ryoko Kawanaka Shoko Sakuma Hiroshi Kokubun Shuhei Tetsu Yugo Tagaito Toshio Igarashi Shan-Guang Liang Tomohiko Aoe |
| author_sort | Ryoko Kawanaka |
| collection | DOAJ |
| 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% (<i>p</i> = 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. |
| first_indexed | 2024-03-09T21:35:33Z |
| format | Article |
| id | doaj.art-9801d84c8098431198880d012e9e2174 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T21:35:33Z |
| publishDate | 2022-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-9801d84c8098431198880d012e9e21742023-11-23T20:45:30ZengMDPI AGJournal of Clinical Medicine2077-03832022-09-011119558710.3390/jcm11195587Effects of Intraoperative Opioid Administration on Postoperative Pain and Pain Threshold: A Randomized Controlled StudyRyoko Kawanaka0Shoko Sakuma1Hiroshi Kokubun2Shuhei Tetsu3Yugo Tagaito4Toshio Igarashi5Shan-Guang Liang6Tomohiko Aoe7Department of Anesthesiology, Teikyo University Chiba Medical Center, Teikyo University, 3426-3 Anesaki, Ichihara City 299-0111, Chiba, JapanDepartment of Anesthesiology, Teikyo University Chiba Medical Center, Teikyo University, 3426-3 Anesaki, Ichihara City 299-0111, Chiba, JapanDepartment of Anesthesiology, Teikyo University Chiba Medical Center, Teikyo University, 3426-3 Anesaki, Ichihara City 299-0111, Chiba, JapanDepartment of Anesthesiology, Teikyo University Chiba Medical Center, Teikyo University, 3426-3 Anesaki, Ichihara City 299-0111, Chiba, JapanDepartment of Anesthesiology, Teikyo University Chiba Medical Center, Teikyo University, 3426-3 Anesaki, Ichihara City 299-0111, Chiba, JapanDepartment of Obstetrics and Gynecology, Teikyo University Chiba Medical Center, Teikyo University, 3426-3 Anesaki, Ichihara City 299-0111, Chiba, JapanDepartment of Obstetrics and Gynecology, Teikyo University Chiba Medical Center, Teikyo University, 3426-3 Anesaki, Ichihara City 299-0111, Chiba, JapanPain Center, Teikyo University Chiba Medical Center, Teikyo University, 3426-3 Anesaki, Ichihara City 299-0111, Chiba, JapanFentanyl 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% (<i>p</i> = 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.https://www.mdpi.com/2077-0383/11/19/5587postoperative painopioid-induced hyperalgesiaopioid misusefentanylremifentanil |
| spellingShingle | Ryoko Kawanaka Shoko Sakuma Hiroshi Kokubun Shuhei Tetsu Yugo Tagaito Toshio Igarashi Shan-Guang Liang Tomohiko Aoe Effects of Intraoperative Opioid Administration on Postoperative Pain and Pain Threshold: A Randomized Controlled Study Journal of Clinical Medicine postoperative pain opioid-induced hyperalgesia opioid misuse fentanyl remifentanil |
| 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 | postoperative pain opioid-induced hyperalgesia opioid misuse fentanyl remifentanil |
| url | https://www.mdpi.com/2077-0383/11/19/5587 |
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