Abstract
The optimal analgesic drug for intravenous patient-controlled analgesia (IV PCA) is required to have a rapid onset and a gradual offset of the analgesic effect as well as having no/little effects of postoperative nausea/vomiting (PONV) , dizziness, or constipation. Fentanyl has some advantages of a rapid onset due to high fat-solubility, and of few uncomfortable side effects such as itching, compared to morphine, which is commonly used for IV PCA. It is also necessary to design drug delivery protocols to obtain an adequate level of analgesia during the postoperative period by estimating the adequate effect-site concentration of fentanyl (1-2 ng/ml) calculated with pharmacokinetic simulation analysis. We evaluated postoperative pain management through intravenous fentanyl administration with a disposable PCA device (background: 20μg/hr, bolus: 20μg/push, lock-out time: 10 minutes) on patients under total intravenous anesthesia with multimodal postoperative pain management combined with local anesthetics and non-steroidal anti-inflammatory drugs (NSAIDs) , and found that this IV PCA protocol was effective and satisfactory because of the low incidence of PONV (<30%) and little additional requirement of analgesics (<20%) .
