The Analgesic Effect of Different Dosing Methods When Using Transdermal Fentanyl Patches after Laparoscopic Cholecystectomy

Lee, Jae In; Kim, Young Jae; Cho, Kwang Rae; Lee, Sang Eun; Kim, Young Hwan; Lim, Se Hoon; Lee, Jeong Han; Lee, Kun Moo; Cheong, Soon Ho; Choi, Young Kyun; Shin, Chee Mahn

Abstract

BACKGROUND
The advances in surgical technology, anesthesia and perioperative care have made it possible to perform laparoscopic cholecystectomy on an outpatient basis. This study was conducted to assess the analgesic effect and the adverse events of different dosing methods when using transdermal fentanyl patches (TDFPs) after laparoscopic cholecystectomy. METHODS: Sixty patients who were to undergo laparoscopic cholecystectomy under general anesthesia were divided into two groups. Group 1: 2 TDFPs that released 12microgram/h were applied after the induction of anesthesia and these 2 patches were removed after 24 hours. Group 2: 2 TDFPs that released 12microgram/h were applied after the induction of anesthesia and one patch was removed after 7 hours and the other patch was removed after 24 hours. The intensity of the postoperative pain was assessed by using a visual analogue scale (VAS) and assessing the adverse events, including dizziness, pruritus and nausea/vomiting, were recorded for 48 hours postoperatively. RESULTS: The VAS score of postoperative pain was not significantly different between the two groups at all times. The incidence of dizziness in groups I and II was 10 and 3, respectively, and the incidence of nausea/vomiting in group I and II was 4 and 0, respectively. The incidences of dizziness and nausea/vomiting in group II were significantly lower than those of group I (P < 0.05). CONCLUSIONS: A dosing method that removes half of the TDFPs (24microgram/h) after 7 hours of application caused a lower incidence of dizziness and nausea/vomiting without any significant difference of postoperative analgesic efficacy, as compared to leaving on both the TDFPs (24microgram/h) for 24 hours after laparoscopic cholecystectomy.