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 2019More...
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
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