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Comparison of the Efficacy and Safety of a Pharmacokinetic Model-Based Dosing Scheme Versus a Conventional Fentanyl Dosing Regimen For Patient-Controlled Analgesia Immediately Following Robot-Assisted Laparoscopic Prostatectomy
- Source :
- Medicine
- Publication Year :
- 2016
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2016.
-
Abstract
- Conventional, intravenous, patient-controlled analgesia, which is only administered by demand bolus without basal continuous infusion, is closely associated with inappropriate analgesia. Pharmacokinetic model-based dosing schemes can quantitatively describe the time course of drug effects and achieve optimal drug therapy. We compared the efficacy and safety of a conventional dosing regimen for intravenous patient-controlled analgesia that was administered by demand bolus without basal continuous infusion (group A) versus a pharmacokinetic model-based dosing scheme performed by decreasing the dosage of basal continuous infusion according to the model-based simulation used to achieve a targeted concentration (group B) following robot-assisted laparoscopic prostatectomy. In total, 70 patients were analyzed: 34 patients in group A and 36 patients in group B. The postoperative opioid requirements, pain scores assessed by the visual analog scale, and adverse events (eg, nausea, vomiting, pruritis, respiratory depression, desaturation, sedation, confusion, and urinary retention) were compared on admission to the postanesthesia care unit and at 0.5, 1, 4, 24, and 48 h after surgery between the 2 groups. All patients were kept for close observation in the postanesthesia care unit for 1 h, and then transferred to the general ward. The fentanyl requirements in the postanesthesia care unit for groups A and B were 110.0 ± 46.4 μg and 77.5 ± 35.3 μg, respectively. The pain scores assessed by visual analog scale at 0.5, 1, 4, and 24 h after surgery in group B were significantly lower than in group A (all P
- Subjects :
- Male
medicine.medical_specialty
Visual analogue scale
Sedation
medicine.medical_treatment
law.invention
Fentanyl
03 medical and health sciences
0302 clinical medicine
Bolus (medicine)
Randomized controlled trial
law
medicine
Humans
030212 general & internal medicine
Dosing
Adverse effect
Aged
Pain Measurement
Prostatectomy
Pain, Postoperative
business.industry
Patient-controlled analgesia
Robotics
Clinical Trial/Experimental Study
General Medicine
Middle Aged
Models, Theoretical
Surgery
Analgesics, Opioid
030220 oncology & carcinogenesis
Anesthesia
Laparoscopy
medicine.symptom
business
Research Article
medicine.drug
Subjects
Details
- ISSN :
- 00257974
- Volume :
- 95
- Database :
- OpenAIRE
- Journal :
- Medicine
- Accession number :
- edsair.doi.dedup.....8c4de264f008de77089595df0deeff16