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Article: A comparison of postoperative cognitive function and pain relief with fentanyl or tramadol patient-controlled analgesia

TitleA comparison of postoperative cognitive function and pain relief with fentanyl or tramadol patient-controlled analgesia
Authors
Issue Date2006
PublisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/jclinane
Citation
Journal Of Clinical Anesthesia, 2006, v. 18 n. 3, p. 205-210 How to Cite?
AbstractStudy Objective: The use of different opioids for patient-controlled analgesia (PCA) may affect postoperative cognitive function differently. Patient-controlled analgesia fentanyl has been shown to preserve cognitive function better than morphine. The effect of PCA tramadol on cognitive function is unknown. This study aims to compare postoperative cognitive function and analgesia of PCA fentanyl or tramadol. Design: Prospective randomized double-blinded study. Setting: Metropolitan teaching hospital. Patients: 30 ASA physical status I, II, and III patients undergoing lower abdominal operations. Interventions: Patients received standard general anesthesia for their operations. Postoperatively, patients received either fentanyl (group F, 10 μg bolus, n = 17) or tramadol (group T, 20 mg bolus, n = 13) for PCA. Group F patients also received fentanyl boluses and group T patients received tramadol boluses intraoperatively. Measurements: Cognitive function was measured using Mini-Mental State Examination and Benton Visual Retention Test (BVRT) preoperatively and on days 1 and 2. Pain was measured by numerical rating scale. Results: No differences were found in postoperative Mini-Mental State Examination or BVRT scores, but significantly fewer (29.4%; 95% confidence interval [CI], 13.3%-53.1%) group F patients were able to complete BVRT compared with group T patients (84.6%; 95% CI, 57.8%-95.7%; 95% CI of difference, 19.4%-74.8%) (P = 0.010) on day 1. In the first 24 hours, group F and group T patients had similar analgesia at rest, but group T patients had better analgesia during cough (mean Numeric Rating Scale, 7.6; 95% CI, 7.0-8.2 vs 6.0; 95% CI, 4.8-7.2, group F vs group T) (P = 0.018; 95% CI of difference, 0.4-2.8). No differences were found in frequency of side effects or patient satisfaction. Conclusions: Tramadol or fentanyl PCA has similar cognitive effects on days 1 and 2; however, patients receiving tramadol PCA are more motivated to undergo cognitively demanding tasks and have slightly better analgesia on postoperative day 1. © 2006 Elsevier Inc. All rights reserved.
Persistent Identifierhttp://hdl.handle.net/10722/67315
ISSN
2015 Impact Factor: 1.284
2015 SCImago Journal Rankings: 0.431
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorNg, KFJen_HK
dc.contributor.authorYuen, TSTen_HK
dc.contributor.authorNg, VMWen_HK
dc.date.accessioned2010-09-06T05:53:54Z-
dc.date.available2010-09-06T05:53:54Z-
dc.date.issued2006en_HK
dc.identifier.citationJournal Of Clinical Anesthesia, 2006, v. 18 n. 3, p. 205-210en_HK
dc.identifier.issn0952-8180en_HK
dc.identifier.urihttp://hdl.handle.net/10722/67315-
dc.description.abstractStudy Objective: The use of different opioids for patient-controlled analgesia (PCA) may affect postoperative cognitive function differently. Patient-controlled analgesia fentanyl has been shown to preserve cognitive function better than morphine. The effect of PCA tramadol on cognitive function is unknown. This study aims to compare postoperative cognitive function and analgesia of PCA fentanyl or tramadol. Design: Prospective randomized double-blinded study. Setting: Metropolitan teaching hospital. Patients: 30 ASA physical status I, II, and III patients undergoing lower abdominal operations. Interventions: Patients received standard general anesthesia for their operations. Postoperatively, patients received either fentanyl (group F, 10 μg bolus, n = 17) or tramadol (group T, 20 mg bolus, n = 13) for PCA. Group F patients also received fentanyl boluses and group T patients received tramadol boluses intraoperatively. Measurements: Cognitive function was measured using Mini-Mental State Examination and Benton Visual Retention Test (BVRT) preoperatively and on days 1 and 2. Pain was measured by numerical rating scale. Results: No differences were found in postoperative Mini-Mental State Examination or BVRT scores, but significantly fewer (29.4%; 95% confidence interval [CI], 13.3%-53.1%) group F patients were able to complete BVRT compared with group T patients (84.6%; 95% CI, 57.8%-95.7%; 95% CI of difference, 19.4%-74.8%) (P = 0.010) on day 1. In the first 24 hours, group F and group T patients had similar analgesia at rest, but group T patients had better analgesia during cough (mean Numeric Rating Scale, 7.6; 95% CI, 7.0-8.2 vs 6.0; 95% CI, 4.8-7.2, group F vs group T) (P = 0.018; 95% CI of difference, 0.4-2.8). No differences were found in frequency of side effects or patient satisfaction. Conclusions: Tramadol or fentanyl PCA has similar cognitive effects on days 1 and 2; however, patients receiving tramadol PCA are more motivated to undergo cognitively demanding tasks and have slightly better analgesia on postoperative day 1. © 2006 Elsevier Inc. All rights reserved.en_HK
dc.languageengen_HK
dc.publisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/jclinaneen_HK
dc.relation.ispartofJournal of Clinical Anesthesiaen_HK
dc.rightsJournal of Clinical Anesthesia. Copyright © Elsevier Inc.en_HK
dc.subject.meshAnalgesia, Patient-Controlleden_HK
dc.subject.meshAnalgesics, Opioid - pharmacologyen_HK
dc.subject.meshCognition - drug effectsen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshFentanyl - pharmacologyen_HK
dc.subject.meshHumansen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshPain, Postoperative - drug therapyen_HK
dc.subject.meshProspective Studiesen_HK
dc.subject.meshTramadol - pharmacologyen_HK
dc.titleA comparison of postoperative cognitive function and pain relief with fentanyl or tramadol patient-controlled analgesiaen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0952-8180&volume=18&spage=205&epage=210&date=2006&atitle=A+comparison+of+postoperative+cognitive+function+and+pain+relief+with+fentanyl+or+tramadol+patient-controlled+analgesiaen_HK
dc.identifier.emailNg, KFJ:jkfng@hkucc.hku.hken_HK
dc.identifier.authorityNg, KFJ=rp00544en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/j.jclinane.2005.08.004en_HK
dc.identifier.pmid16731323-
dc.identifier.scopuseid_2-s2.0-33646764235en_HK
dc.identifier.hkuros120209en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-33646764235&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume18en_HK
dc.identifier.issue3en_HK
dc.identifier.spage205en_HK
dc.identifier.epage210en_HK
dc.identifier.isiWOS:000238130400008-
dc.publisher.placeUnited Statesen_HK

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