Acute high dose-fentanyl exposure produces hyperalgesia and tactile allodynia after coronary artery bypass surgery
European Review for Medical and Pharmacological Sciences, cilt.18, sa.22, ss.3425-3434, 2014 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 18 Sayı: 22
- Basım Tarihi: 2014
- Dergi Adı: European Review for Medical and Pharmacological Sciences
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
- Sayfa Sayıları: ss.3425-3434
- Anahtar Kelimeler: Fentanyl, Opioid induced hyperalgesia, Tactile allodynia, Von Frey filaments
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
OBJECTIVE: Opioid-induced hyperalgesia is well known complication of acute high dose and chronic opioid therapy. In this study, we evaluated development of opioid-induced hyperalgesia following intraoperative short-term use of ì-opioid agonist fentanyl after coronary artery bypass surgery. PATIENTS AND METHODS: 100 patients undergoing elective coronary artery bypass graft surgery is divided into two groups. In group I (low dose), anesthesia was induced with propofol 1-2.5 mg/kg and fentanyl 2 mcg/kg, in group II (high dose) fentanyl 40-70 mcg/kg was used. In group I, propofol 5-10 mg/kg/h, fentanyl 1-3 mcg/kg/h, in group II fentanyl 5-10 mcg/kg/h was used for maintenance of anesthesia. The tactile and thermal thresholds were measured before surgery and in 1st, 3rd and 7th postoperative days by using Von Frey filaments and a thermal source, respectively. RESULTS: Tactile thresholds were significantly decreased at the first (6.08 ± 0.21 and 3.76 ± 0.13 g; p > 0.001) and third (6.76 ± 0.24 and 4.96 ± 0.16 g; p > 0.001) postoperative days compared to baseline preoperative values (7.72 ± 0.26, and 7.60 ± 0.21 g; p = 816) in two groups. Postoperative 1st(13.45 ± 0.33 and 10.05 ± 0.24 sec; p > 0.001) and 3rd day (14.77 ± 0.28 and 13.17 ± 0.26 sec; p > 0.001) assessments showed a statistically significant thermal hyperalgesia compared to the preoperative baseline values (16.67 ± 0.51 and 16.45 ± 0.42 sec; p = 0.997) in two groups. This decrease in both tactile and thermal thresholds returned to baseline control values at the 7th day of measurement. CONCLUSIONS: Our results showed that patients undergoing coronary artery bypass surgery receiving fentanyl anesthesia developed postoperative tactile allodynia and thermal hyperalgesia and this was more prominent in high dose group.