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REGIONAL ANESTHESIA AND PAIN MEDICINE

A Comparison of Intrathecal Analgesia with Fentanyl or Sufentanil After Total Hip Replacement

Department of Anesthesiology, University Hospital of Geneva, Geneva, Switzerland

Address correspondence and reprint requests to Roxane Fournier, MD, Département d’Anesthésiologie, Hôpital Cantonal Universitaire, CH-11 Geneve 14, Switzerland. Address e-mail to Roxane.Fournier{at}hcuge.ch

We designed this study to compare the postoperative analgesic effects of intrathecal fentanyl and sufentanil, the end points being onset, quality, and duration of action. A total of 42 geriatric patients, scheduled for elective total hip replacement under continuous spinal anesthesia, were randomized in two double-blinded groups as soon as they experienced a pain score higher than 3 of 10 on the visual analog scale in the recovery room. Either 7.5 µg sufentanil or 40 µg fentanyl in 2 mL normal saline were intrathecally administered. Pain scores, rescue analgesia (ketorolac and morphine), and adverse effects (respiratory depression, postoperative nausea and vomiting, and itching) were recorded for 24 h after surgery. In both groups, comparing 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), and 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 requirements during the first 24 h. We conclude that, after total hip replacement, both lipid soluble opioids produce excellent analgesia with comparable onset, duration of action, and low incidence of minor adverse effects.

Implications: We compared the postoperative analgesic properties of 40 µg intrathecal fentanyl and 7.5 µg sufentanil after total hip replacement. Both opioids provided satisfactory analgesia, with comparable onset (11 ± 8 vs 9 ± 9 min) and duration of action (214 ± 120 vs 241 ± 102 min), as well as low incidence of minor side effects.

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				J.-D. Roy, L. Massicotte, M.-P. Sassine, R. F. Seal, and A. Roy A Comparison of Intrathecal Morphine/Fentanyl and Patient-Controlled Analgesia with Patient-Controlled Analgesia Alone for Analgesia After Liver Resection Anesth. Analg., October 1, 2006; 103(4): 990 - 994. [Abstract] [Full Text] [PDF]

				R. Fournier, E. Van Gessel, A. Weber, and Z. Gamulin Epinephrine and clonidine do not improve intrathecal sufentanil analgesia after total hip replacement{dagger} Br. J. Anaesth., October 1, 2002; 89(4): 562 - 566. [Abstract] [Full Text] [PDF]

				C. M. Palmer Continuous Intrathecal Sufentanil for Postoperative Analgesia Anesth. Analg., January 1, 2001; 92(1): 244 - 245. [Abstract] [Full Text] [PDF]