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, Younglan Kwak

Research output: Contribution to journalArticle

2 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

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Patient-Controlled Analgesia
Postoperative Nausea and Vomiting
Fentanyl
Spine
Randomized Controlled Trials
Patient Satisfaction
Analgesics
Pain
Incidence
Antiemetics
Visual Analog Scale
Nausea
Outcome Assessment (Health Care)
propacetamol

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology
  • Anesthesiology and Pain Medicine

Cite this

@article{1a1d2e4045834418b5b28ebd0bc130c6,
title = "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",
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.",
author = "Kim, {Eun Jung} and Shim, {Jae Kwang} and Sarah Soh and Song, {Jong Wook} and Lee, {Se Ryeon} and Younglan Kwak",
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language = "English",
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pages = "316--322",
journal = "Journal of Neurosurgical Anesthesiology",
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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. / Kim, Eun Jung; Shim, Jae Kwang; Soh, Sarah; Song, Jong Wook; Lee, Se Ryeon; Kwak, Younglan.

In: Journal of Neurosurgical Anesthesiology, Vol. 28, No. 4, 24.09.2016, p. 316-322.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Patient-controlled analgesia with propacetamol-fentanyl mixture for prevention of postoperative nausea and vomiting in high-risk patients undergoing spine surgery

T2 - A randomized controlled trial

AU - Kim, Eun Jung

AU - Shim, Jae Kwang

AU - Soh, Sarah

AU - Song, Jong Wook

AU - Lee, Se Ryeon

AU - Kwak, Younglan

PY - 2016/9/24

Y1 - 2016/9/24

N2 - 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.

AB - 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.

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