Intrathecal sufentanil for intraoperative and postesophagectomy pain relief.

OBJECTIVES

The present study compares the analgesic properties of intrathecal (IT group) and intravenous (IV group) sufentanil in postoperative pain relief.

METHODS

This randomized, single blinded study was performed on patients awaiting transhiatal esophagectomy. The patients were randomly allocated to receive sufentanil intrathecally or intravenously. Sufentanil consumption during the operation, pain score following the operation based on visual analog scale (VAS) and the morphine requirement for postoperative analgesia were assessed during the first 24 hours.

RESULTS

Fifty patients were divided in two groups. During the operation, the opioid requirement was higher in the IV group, whereas the morphine requirement during the first 24 hours after the operation was the same in both groups. The duration of effective postoperative analgesia was longer in patients in the IT group. VAS pain scores were significantly lower during the first 2 hours postoperatively in the IT group. The incidence of side effects such as nausea, vomiting, headache and respiratory depression was infrequent in both groups.

CONCLUSIONS

Preoperative IT sufentanil can be used as a booster to achieve rapid and effective analgesia not only during the operation but also during the immediate postoperative period.