Patient-controlled analgesia with propacetamol-fentanyl mixture for prevention of postoperative nausea and vomiting in high-risk patients undergoing spine surgery: A randomized controlled trial

Eun Jung Kim, Jae Kwang Shim, Sarah Soh, Jong Wook Song, Se Ryeon Lee, Young Lan Kwak

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: This randomized trial evaluated the effect of intravenous patient-controlled analgesia (IV-PCA) based on fentanyl mixed with either propacetamol or an equivalent volume of normal saline on postoperative nausea and vomiting (PONV) in highly susceptible patients undergoing spinal surgery. Materials and Methods: One hundred eight nonsmoking female patients were randomly and evenly allocated to receive IV-PCA with either propacetamol (4 g) or normal saline mixed to fentanyl (20 μg/kg). Primary study outcome was PONV incidence at 24 hours postsurgery. Secondary outcomes were nausea severity, pain intensity (100-mm visual analog scale), use of rescue antiemetics and analgesics, patient satisfaction, and adverse events at 6, 12, and 24 hours postsurgery. Results: Postsurgery, the propacetamol versus normal saline group had lower PONV incidence at 24 hours (41% vs. 66%, P=0.011); pain intensity at rest and rescue analgesic requirements at 6 to 12 hours (30±15 vs. 41±19, P=0.008; and 25% vs. 49%, P=0.036, respectively) and at 12 to 24 hours (25±15 vs. 35±17, P=0.008; and 19% vs. 42%, P=0.044, respectively); and higher patient satisfaction score (6.4±1.4 vs. 5.7±1.8, P=0.028). Conclusions: In patients undergoing spinal surgery and at risk of developing PONV, continuous IV-PCA based on propacetamol mixed to fentanyl, relative to fentanyl alone, effectively reduced the incidence of PONV, pain intensity at rest, and additional use of rescue analgesics with higher patient satisfaction.

Original languageEnglish
Pages (from-to)316-322
Number of pages7
JournalJournal of Neurosurgical Anesthesiology
Volume28
Issue number4
DOIs
Publication statusPublished - 2016 Sep 24

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology
  • Anesthesiology and Pain Medicine

Fingerprint Dive into the research topics of 'Patient-controlled analgesia with propacetamol-fentanyl mixture for prevention of postoperative nausea and vomiting in high-risk patients undergoing spine surgery: A randomized controlled trial'. Together they form a unique fingerprint.

  • Cite this