Optimal Dose of Fentanyl in Continuous Epidural Infusion According to the Patient's Height after Thoracic Surgery

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  • YAMAGISHI Akio
    Department of Anesthesiology, Obihiro National Hospital
  • ASAI Yuichi
    Department of Anesthesiology, Obihiro National Hospital
  • IWASAKI Hiroshi
    Department of Anesthesiology and Critical Care Medicine, Asahikawa Medical College

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  • 身長による持続硬膜外鎮痛時のフェンタニル至適投与量の検討

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  We investigated the analgesic effect and side effects of continuous epidural infusion of fentanyl after thoracic surgery. Sixty patients were included in this study. Patients were randomly allocated to four groups. Patients less than 155cm in height were divided into group L1 (2.5μg/ml fentanyl) and group L2 (3.75μg/ml fentanyl) , and patients more than 155cm in height were divided into group H1 (1.66μg/ml fentanyl) and group H2 (2.5μg/ml fentanyl) . Epidural infusion was 4ml/h in patients less than 155cm in height and 6ml/h in patients more than 155cm in height. Pain scores (visual analogue scale: VAS) were assessed at 1, 3, 6, 12, 24 and 48 hrs after surgery. Degrees of satisfaction regarding pain relief and complications during a period of 48 hrs after surgery were compared. Pain scores in the group H1 were significantly higher than those in the other groups at 3, 6 and 12 hrs after surgery. There was more postoperative nausea and vomiting in the group L2 than in the other groups. The average weight in the group L2 was significantly lighter than those in the other groups. In conclusion, weight must be taken into consideration when using continuous epidural infusion of 0.2% ropivacaine with fentanyl.

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