Comparative study of thoracic epidural fentanyl with sufentanil for postoperative pain relief in thoracic surgery

ABSTRACT

Both fentanyl and sufentanil have been used, either alone or with local anesthetics, for thoracic epidural analgesia. This study was undertaken to compare quality and safety of thoracic epidural fentanyl and thoracic epidural sufentanil for providing postoperative analgesia for 48 hours after thoracic surgery. In a prospective randomized, controlled study, 70 patients age group between 20-60 years, of either gender, scheduled for routine thoracic surgery were randomly distributed into two groups of 35 patients each. Postoperatively, fentanyl 50 ug in Group-F and sufentanil 20 ug in Group-S, diluted in 10 ml of normal saline was injected in the thoracic epidural space [between T6 - T8] through the catheter and then repeated 6 hourly. Pain intensity score, onset of analgesia, number of top-ups required and overall patient satisfaction score were recorded. Mean onset of analgesia was 10.31 +/- 1.5 min with sufentanil group as against 14.23 +/- 1.2 min with fentanyl group. Pain Intensity [PPI] score < 1 was observed in 78.21% observations belonging to sufentanil group and in 50% observations belonging to fentanyl group. Twenty five patients [71.4%] from sufentanil group and 30 patients [85.7%] from fentanyl group required rescue analgesia. The patient's feedback on pain relief was graded as very good or good by 78.5% of the patients in Group-S and 69% patients in Group-F. Though both drugs are equally safe, sufentanil is faster acting, more potent and efficient analgesic than fentanyl when used for postoperative pain relief in thoracic surgeries via thoracic epidural approach: