Comparison of the effectiveness of fentanyl versus morphine for severe postoperative pain management. A randomized, double blind, clinical trial

  • Adriana Margarita Cadavid-Puentes a. Universidad de Antioquia, Medellín, Colombia. b. Unidad del Dolor, Hospital San Vicente Fundación, Medellín, Colombia
  • Francisco José Bermúdez-Guerrero Unidad del Dolor, Hospital San Vicente Fundación, Medellín, Colombia
  • Olga Giraldo-Salazar a. Universidad de Antioquia, Medellín, Colombia. b. Unidad del Dolor, Hospital San Vicente Fundación, Medellín, Colombia
  • Fabio Muñoz-Zapata Universidad de Antioquia, Medellín, Colombia
  • Juan Otálvaro-Henao Universidad de Antioquia, Medellín, Colombia
  • Juliana Ruíz-Sierra Universidad de Antioquia, Medellín, Colombia
  • Julián Alvarado-Ramírez Universidad de Antioquia, Medellín, Colombia
  • Gilma Hernández-Herrera Universidad de Antioquia, Medellín, Colombia
  • Daniel Camilo Aguirre-Acevedo Universidad de Antioquia, Medellín, Colombia
Keywords: Analgesics, postoperative, Fentanyl, Morphine, Randomized controlled trial, Opioid pain

Abstract

Introduction: Intravenous rescue analgesia in the postoperative anesthesia care unit (PACU) is the most effective method for reducing postoperative pain (POP) when perioperative multimodal analgesia fails to control it. Appropriate analgesia during these first postoperative hours may prevent morbidity associated with pain. 

Objective: To compare the effectiveness of intravenous morphine versus fentanyl in the PACU for reducing severe POP. 

Methods: Randomized, prospective, double blind trial that included patients with severe POP using VAS in the PACU. Rescue was performed on one group with 01 mg/kg morphine and with another with 1 mcg/kg of fentanyl every 5 min intravenously until pain was reduced from severe to mild (VAS<4). 30 patients were included in both groups. 

Results: There were no significant differences in the percentage of patients with reduction of severe POP to mild 5 min after the injection of morphine or fentanyl, or in the subsequent rescue analgesia intervals (p > 0.05). Similarly, there were no significant differences in mean VAS (95% CI) in morphine or fentanyl groups beginning 5 min after the first analgesic dose (p > 0.05) between the groups. There were no significant differences in side effects such as respiratory depression, nausea, vomiting or pruritus (p = 1.0). There was a high satisfaction in both groups (p > 0.05). 

Conclusions: Morphine and fentanyl were equally effective in treating severe POP after 5 min and following intervals after rescue analgesia was initiated, during 25 min at PACU, with no differences in efficacy or adverse effects between groups.

Register # NCT02145975 clinical-trials.gov, prospective.

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How to Cite
1.
Cadavid-Puentes AM, Bermúdez-Guerrero FJ, Giraldo-Salazar O, Muñoz-Zapata F, Otálvaro-Henao J, Ruíz-Sierra J, Alvarado-Ramírez J, Hernández-Herrera G, Aguirre-Acevedo DC. Comparison of the effectiveness of fentanyl versus morphine for severe postoperative pain management. A randomized, double blind, clinical trial. Colomb. J. Anesthesiol. [Internet]. 2017Apr.1 [cited 2021Jan.26];45(2):100-7. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/244

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Published
2017-04-01
How to Cite
1.
Cadavid-Puentes AM, Bermúdez-Guerrero FJ, Giraldo-Salazar O, Muñoz-Zapata F, Otálvaro-Henao J, Ruíz-Sierra J, Alvarado-Ramírez J, Hernández-Herrera G, Aguirre-Acevedo DC. Comparison of the effectiveness of fentanyl versus morphine for severe postoperative pain management. A randomized, double blind, clinical trial. Colomb. J. Anesthesiol. [Internet]. 2017Apr.1 [cited 2021Jan.26];45(2):100-7. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/244
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