山梨医科大学雑誌　第11巻3号　049-052(1996)

Subcutaneous versus Epidural Administration of Fentanyl for
Postoperative Analgesia

Hisanori MATSUOKA, Akihiko NONAKA, Satoshi KASHIMOTO, Toshiaki YAMAGUCHI,
Masako UCHIDA, and Teruo KUMAZAWA

Abstract: Contenuous subcutaneous infusion of opioids may be a preferable alternative for postoperatlve pain relief in patients without an epidural catheter. Thls study compared the efficacy of subcutaneous fentanyl with that of epidural fentanyl for management of postoperative pain. Twenty patients scheduled for gynecological surgery were randomly assigned to receive subcutaneous (SQ group) or epidura1 (EP group) fentanyl over 24 hr via the allocated route. About 30 minutes before the end of surgery, patients in the SQ group received an initial bolus of fentanyl (100 μg) subcutaneously followed by an infusion of 33 μg/hr for 24 hr by the subcutaneous route using a disposable infusion device (DIB catheter, DIB International Inc.,Japan). While patients in the EP group received an initial dose of fentanyl (50 μg) through an epidural catheter followed by an infusion rate of 17 μg/hr for 24 hr using the same device. There was no significant difference in the visual analogue score (VAS) at 24 hr between the two groups, though VAS (4.3 ±1.8) in the SQ group was significantly higher than that in the EP group (2.1±1.5) at 3 hr after surgery. No patients had severe complications. We conclude that continuous subcutaneous infusion of fentanyl seems to provide simple and relatively effective analgesia after surgery, though epidural injection provides better pain relief.

Key words: Anesthetic technique; epidural, subcutaneous, Analgesics; fentanyl, Pain; postoperative




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