Evaluation of basal rate infusion in intravenous patient-controlled analgesia for post-cesarean section pain management: A randomized pilot study.
Medicine (Baltimore)
; 103(8): e37122, 2024 Feb 23.
Article
en En
| MEDLINE
| ID: mdl-38394544
ABSTRACT
OBJECTIVE:
Administering opioids via intravenous patient-controlled analgesia is a prevalent approach for managing postoperative pain. Nevertheless, due to concerns about opioid-related side effects and the potential for opioid tolerance, there is a growing emphasis on adopting opioid-sparing techniques for postoperative pain management. We aimed to investigate the effect of adding a basal rate infusion in fentanyl-based IVA following a cesarean section (CS).METHOD:
Forty-eight patients, who received pain management through IVA after CS, were assigned randomly into 3 groups based on the background ratesetting:
Group 0 (0 mcg/hour, nâ =â 16), Group 1 (15 mcg/hour, nâ =â 16), and Group 2 (30 mcg/hour, nâ =â 16). We assessed the impact of the basal infusion rate on opioid consumption and the visual analog scale (VAS) scores during the first 48 hours post-CS and also investigated opioid-induced side effects and the requirement for rescue analgesics in the ward during the first 48 hours after CS.RESULTS:
In the initial 24 hours following CS, fentanyl consumption significantly increased in Group 2 compared with Group 0 and Group 1 (Pâ =â .037). At 24 hours, VAS scores both at rest and during movement, tended to decrease, as the basal rate increased; however, no significant differences were observed between the groups (Pâ =â .218 and 0.827, respectively). Between the first 24- and 48-hours post-CS, fentanyl consumption showed a marked increase in both Group 1 and Group 2 compared to Group 0 (Pâ <â .001). At 48 hours, the VAS scores at rest displayed a trend toward reduction; however, no significant differences between groups were evident (Pâ =â .165). Although the incidence of opioid-induced complications was noted, no statistically significant differences were recorded between groups during the initial 24 hours and subsequent 24 to 48 hours period (Pâ =â .556 and Pâ =â .345, respectively).CONCLUSION:
The inclusion of a basal fentanyl infusion in the IVA protocol did not provide any advantages over an IVA devoid of a basal rate infusion in managing acute pain following CS.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Analgesia Controlada por el Paciente
/
Analgésicos Opioides
Límite:
Female
/
Humans
/
Pregnancy
Idioma:
En
Revista:
Medicine (Baltimore)
Año:
2024
Tipo del documento:
Article