An extensive experience with postoperative pain relief using postoperative fentanyl infusion

B. B. Chien, R. G. Burke and D. J. Hunter
Department of Anesthesiology, Flagstaff Medical Center, AZ 86001.

From October 1, 1987 through December 31, 1989, 517 patients who were undergoing both thoracic and abdominal surgical procedures were treated for postoperative pain with epidural fentanyl citrate infusion under the direction of an anesthesia pain service. Infusion rates of 4 micrograms/mL of solution were essentially the same for all subjects. Sixty-five percent of patients experienced superior pain control without the use of adjunctive analgesia. Twenty-eight percent of subjects achieved satisfactory pain control but required additional low-dose analgesics. Only 7% of patients remained uncomfortable despite additional intravenous narcotic administration. There were no deaths or respiratory arrests. Six percent of patients experienced nausea, and 0.8% of the cohort required catheterization for urinary retention. This technique of postoperative pain control was safe and provided excellent results. Catheter position was a major determinant of the efficacy of the method.