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Is Intravenous Long-Acting Opioid(Morphine) Associated with More Postoperative Hypoxemia than Short-Acting Opioid (Fentanyl) after Non-Cardiac Surgery?

14 Pages Posted: 27 Feb 2019

See all articles by A. Ibrahim Ahmed

A. Ibrahim Ahmed

Zagazig University

M. Farid Doaa

Zagazig University

T. Eldourgham Lobna

Zagazig University

Abdelfattah Kamel Alshaimaa

Zagazig University - Anesthesia and Intensive Care Department

More...

Abstract

Background: Respiratory depression, and analgesia produced by opioid are linked by their action on U-opioid receptor. Fentanyl titration has been touted to cause less postoperative respiratory complications  than morphine.

Objective: To compare between intravenous long-acting opioid (Morphine), and short-acting opioid (Fentanyl) regarding postoperative hypoxemia after non-cardiac surgery.

Patients and methods: A prospective randomized clinical trial done on 52 patients are divided equaly into two groups: Group M (Morphine) received (0.1mg/kg), and Group F (Fentanyl) received (1ug/kg) during induction.In recovery room, for a VAS =4 or more, patients in Group M received 5mg as bolus, and re-assessed after 5 min.(total allowed dose 15mg/3-4h). For Group F 50ug as a bolus, could be repeated (total allowed dose 100ug/1-2h.).

Result(s): There were no significant difference between two groups as regard RR, SPO2 (P value<0.05) except significally higher RR in final,and prefinal reading of fentanyl group, and higher SPO2 in first 5 min., 28h, and 40h than morphine group. VAS show no significant differrance between two groups except fentanyl group show significally high VAS in first three  hours.Nausea,vomiting, and itiching show significant high incidence in morphine group than fentanyl group (P value>0.05).

Conclusion(s): Intravenous morphine is not associated with more hypoxemia than intravenous fentanyl after non-cardiac surgery with  effective rescue analgesia.

Funding Statement: Zagazig University, Faculty of Medicine

Declaration of Interests: Author's declare "None".

Ethics Approval Statement: The IRB has reviewed and assessed the study regarding the potential risks and benefits based on the Declaration of Helsinski. The "ratio" risk to benefit is reasonable, given the goals of the study. The variables assessed, including the proposed subject populations, proposed procedures, and scientific background are supporting the study. The IRB approved that it is within the ethical guidelines as outlined in the Declaration of Helsinki.

Keywords: opioid, morphine, fentanyl, postoperative, and hypoxemia

Suggested Citation

Ahmed, A. Ibrahim and Doaa, M. Farid and Lobna, T. Eldourgham and Alshaimaa, Abdelfattah Kamel, Is Intravenous Long-Acting Opioid(Morphine) Associated with More Postoperative Hypoxemia than Short-Acting Opioid (Fentanyl) after Non-Cardiac Surgery? (October 20, 2018). Available at SSRN: https://ssrn.com/abstract=3271435

A. Ibrahim Ahmed

Zagazig University

Zagazig
Egypt

M. Farid Doaa

Zagazig University

Zagazig
Egypt

T. Eldourgham Lobna

Zagazig University

Zagazig
Egypt

Abdelfattah Kamel Alshaimaa (Contact Author)

Zagazig University - Anesthesia and Intensive Care Department ( email )

Zagazig
Egypt

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