Le fentanyl transdermique pour l'analgésie post-opératoire en chirurgie cardiaque

Jimmy Côté, Alain Dumas, Pascal Daleau, Jimmy
Objective: To compare the efficacy of transdermal fentanyl to the usual analgesia administered in patients having undergone a mammo-coronary bypass at the Laval Hospital. Methods: An open, controlled and randomized study was conducted in patients having had one or many mammo-coronary bypasses. Doses ranging from 25-50 mg/h were used and adjusted according to body weight. Visual analog scales, narcotic analgesic consumption records and respiratory rate measurements were used. Results: Fifteen
more » ... Results: Fifteen patients were included in the trans-dermal fentanyl group while 9 patients were included in the control group. Average scores on the visual analog scales were 1.91±0.27 and 3.25±0.40 (p=0.0046) for the case and control groups, respectively. Per 8-hour period , patients in the transdermal fentanyl group needed less morphine (per mg equivalent) breakthrough dosing compared to the control group (4.8±0.93 mg vs 8.3±1, 22 mg; p=0.0328). Average respiratory rate did not differ between the two treatment groups (p=0.39). Conclusion: At doses ranging from 25-50 mg/h, trans-dermal fentanyl produces significant relief from baseli-ne pain in post-cardiac surgery. This therapeutic alternative can be applied to similar clinical situations.