Intravenous Patient-Controlled Remifentanil Versus Paracetamol in Post-Operative Pain Management in Patients Undergoing Coronary Artery Bypass Graft Surgery
| Author | Alireza Jahangiri Fard | en |
| Author | Touraj Babaee | en |
| Author | Seyed Mostafa Alavi | en |
| Author | Ali Akbar Nasiri | en |
| Author | Seyed Mohamad Mehran Ghoreishi | en |
| Author | Noor Mohammad Noori | en |
| Author | Maziar Mahjoubifard | en |
| Issued Date | 2014-12-01 | en |
| Abstract | Background: Pain management after cardiac surgery has been based on parenteral long-acting opioids such as morphine. The other alternatives are paracetamol and remifentanil. Objectives: In this prospective, double-blind, randomized study, we compared the efficacy of intravenous patient-controlled analgesia (IV-PCA) paracetamol and remifentanil for post cardiac surgery pain relief. Materials and Methods: One-hundred patients scheduled for elective coronary artery bypass grafting from May to October 2011, were randomized into two groups after the surgery. For the first group (group R, n = 50, with mean age of 58.16 ± 11.80), the IV-PCA protocol was remifentanil infusion 100 μg/h; bolus of 25 μg and lockout time of 15 minutes. In the second group (group P, n = 50, with mean age of 53.8 ± 15.08), patients received paracetamol 15 mg/kg as a bolus at the end of surgery and then IV-PCA protocol was 100 μg/h, bolus of 25 μg; and lockout time of 15 minutes. Pain was assessed with visual analog scale score (VAS) in the first 24 hours after surgery for seven times. Results: The trend of pain scores did not have any significantly difference between group R and group P except for hour 8 and hour 18 after surgery that VAS was significantly lower in group P than group R (P = 0.031, P = 0.023, respectively). Respiratory rate (RR) was also statistically lower in group R comparing to group P in all seven evaluating times. The groups were similar in terms of hemodynamic, ABG results (except for PaO2, which was significantly lower in group R than group P at 6 evaluating times), intubation time, renal function tests, and incidences of atelectasis, myocardial infarction or adverse effects. Conclusions: Both PCA techniques provided effective pain scores (< 3) after cardiac surgery; but generally, PCA-paracetamol infusion has a better analgesic effect. | en |
| DOI | https://doi.org/10.5812/aapm.19862 | en |
| Keyword | Remifentanil | en |
| Keyword | Patient-Controlled Analgesia | en |
| Keyword | Cardiac Surgery | en |
| Publisher | Brieflands | en |
| Title | Intravenous Patient-Controlled Remifentanil Versus Paracetamol in Post-Operative Pain Management in Patients Undergoing Coronary Artery Bypass Graft Surgery | en |
| Type | Research Article | en |
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