Abstract
We evaluated the efficacy, safety, and disadvantages of pain management associated with fentanyl intravenous nurse-controlled analgesia (iv-NCA) following cardiac surgery with sternotomy. Fifty-two adult patients who underwent cardiac surgeries with sternotomy were enrolled into a prospective study. The general anesthesia and care in ICU were performed in standard manner. Patients received either fentanyl iv-NCA (group F 25: 25mcg/hr+25mcg fentanyl/dose, lockout time 10 minutes; n=27) or fentanyl iv-NCA (group F 50: 50mcg/hr+25mcg fentanyl/dose, lockout time 10 minutes; n=25) after extubation in the ICU. Bolus requests, total given dose of fentanyl, vital signs, and adverse effects were compared between the groups. Bolus requests were similar between the groups, whereas 6 patients in group F 25 had a need for other analgesics. On the other hand, we discontinued iv-NCA in 6 patients in group F 50 because of adverse effects. We conclude that fentanyl iv-NCA (25mcg/hr+25mcg fentanyl/dose, lockout time 10 minutes) can be safely used as adjuvant treatment whereas fentanyl iv-NCA (50mcg/hr+25mcg fentanyl/dose, lockout time 10 minutes) may be overdose after cardiac surgery with sternotomy.
