Korean J Anesthesiol.  2011 Jan;60(1):30-35. 10.4097/kjae.2011.60.1.30.

Intravenous patient-controlled analgesia to manage the postoperative pain in patients undergoing craniotomy

• Na HS
• An SB
• Park HP
• Lim YJ
• Hwang JW
• Jeon YT
• Min SW

• KMID: 1827995
• DOI: http://doi.org/10.4097/kjae.2011.60.1.30

Abstract

BACKGROUND
This randomized controlled study evaluated the efficacy of intravenous patient-controlled analgesia (IV-PCA) with fentanyl and ketorolac for neurosurgical patients, and compared the effectiveness of IV-PCA with intermittent analgesics injection.
METHODS
The patients undergoing craniotomy were randomly assigned to two groups. Patients of group P (n = 53) received fentanyl (0.2 microg/kg/hr) and ketorolac (0.3 mg/kg/hr) via IV-PCA, and those of group N (n = 53) received intermittent fentanyl or ketorolac injection as needed. Pain was evaluated using a 0-10 visual analogue scale (VAS) at postoperative 1, 4, and 24 hr. The amount of infused analgesic drugs, Glasgow Coma Scale (GCS) score, systolic arterial pressure, heart rate, respiratory rate, and the incidence of nausea and miosis were measured at the same time points.
RESULTS
Although VAS of pain (VASp) was comparable at postoperative 1 hr (P = 0.168) between the two groups, the group P had significantly lower VASp at postoperative 4 hr (P = 0.007) and 24 hr (P = 0.017). In group P, less analgesic drugs were administered at postoperative 1 hr, and more analgesic drugs were administered at postoperative 24 hr. There were no differences between two groups with respect to nausea, GCS, systolic arterial pressure, and heart rate. IV-PCA did not further incur respiratory depression or miosis.
CONCLUSIONS
IV-PCA with fentanyl and ketorolac after craniotomy is more effective analgesic technique, without adverse events, than the intermittent administration of analgesics.

Keyword

Craniotomy; Fentanyl; Ketorolac; Patient-controlled analgesia

MeSH Terms

Analgesia, Patient-Controlled
Analgesics
Arterial Pressure
Craniotomy
Fentanyl
Glasgow Coma Scale
Heart Rate
Humans
Incidence
Ketorolac
Miosis
Nausea
Pain, Postoperative
Respiratory Insufficiency
Respiratory Rate
Analgesics
Fentanyl
Ketorolac