What epidural opioid results in the best analgesia outcomes and fewest side effects after surgery?: A meta-analysis of randomized controlled trials

Anesthesia and Analgesia

Volumn 119, Issue 4, 2014, Pages 965-977

  Youssef, Nayer ^a   Orlov, David ^b   Alie, Tristan ^a   Chong, Matthew ^a   Cheng, Ji ^a,c   Thabane, Lehana ^a,c   Paul, James ^a  

^a MCMASTER UNIVERSITY   (Canada)

^b UNIVERSITY OF TORONTO   (Canada)

^c ST JOSEPH S HEALTH CENTRE   (Canada)

Author keywords

[No Author keywords available]

Indexed keywords

FENTANYL; MORPHINE; OPIATE; SUFENTANIL; NARCOTIC ANALGESIC AGENT;

ARTICLE; EPIDURAL ANESTHESIA; HUMAN; HYPOTENSION; META ANALYSIS; POSTOPERATIVE ANALGESIA; POSTOPERATIVE NAUSEA AND VOMITING; PRURITUS; RANDOMIZED CONTROLLED TRIAL (TOPIC); RESPIRATION DEPRESSION; SEDATION; SIDE EFFECT; TREATMENT OUTCOME; VISUAL ANALOG SCALE; ANALGESIA; DRUG EFFECTS; PAIN MEASUREMENT; PAIN, POSTOPERATIVE; PROCEDURES;

ANALGESIA, EPIDURAL; ANALGESICS, OPIOID; HUMANS; PAIN MANAGEMENT; PAIN MEASUREMENT; PAIN, POSTOPERATIVE; RANDOMIZED CONTROLLED TRIALS AS TOPIC; TREATMENT OUTCOME;

EID: 84914094885     PISSN: 00032999     EISSN: 15267598     Source Type: Journal    
DOI: 10.1213/ANE.0000000000000377     Document Type: Article

References (55)

1. Block BM, Liu SS, Rowlingson AJ, Cowan AR, Cowan JA Jr, Wu CL. Effcacy of postoperative epidural analgesia: a meta-analysis. JAMA 2003;290:2455-63
2. Wu CL, Cohen SR, Richman JM, Rowlingson AJ, Courpas GE, Cheung K, Lin EE, Liu SS. Effcacy of postoperative patient-controlled and continuous infusion epidural analgesia versus intravenous patient-controlled analgesia with opioids: a meta-analysis. Anesthesiology 2005;103: 1079-88
3. Wheatley RG, Schug SA, Watson D. Safety and effcacy of postoperative epidural analgesia. Br J Anaesth 2001;87: 47-61
4. Gourlay GK, Cherry DA, Cousins MJ. Cephalad migration of morphine in CSF following lumbar epidural administration in patients with cancer pain. Pain 1985;23:317-26
5. Bromage PR, Camporesi EM, Durant PA, Nielsen CH. Rostral spread of epidural morphine. Anesthesiology 1982;56:431-6
6. de Leon-Casasola OA, Lema MJ. Postoperative epidural opioid analgesia: what are the choices? Anesth Analg 1996;83:867-75
7. Roy SD, Flynn GL. Solubility and related physicochemical properties of narcotic analgesics. Pharm Res 1988;5:580-6
8. Haynes RB, Wilczynski N, McKibbon KA, Walker CJ, Sinclair JC. Developing optimal search strategies for detecting clinically sound studies in MEDLINE. J Am Med Inform Assoc 1994;1:447-58
9. Lowe NK. The nature of labor pain. Am J Obstet Gynecol 2002;186:S16-24
10. Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJ, Gavaghan DJ, McQuay HJ. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials 1996;17:1-12
11. Coppe E, Willaert J. Postoperative analgesia for major abdominal surgery with continuous thoracic epidural infusion of bupi-vacaine with sufentanil, versus bupivacaine with morphine. A randomized double blind study. Acta Anaesthesiol Belg 1992;43:131-7
12. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, Clarke M, Devereaux PJ, Kleijnen J, Moher D. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol 2009;62: e1-34
13. Chaney MA. Side effects of intrathecal and epidural opioids. Can J Anaesth 1995;42:891-903
14. Cousins MJ, Bridenbaugh PO, Carr DB, Horlocker TT. Cousins and Bridenbaugh's Neural Blockade in Clinical Anesthesia and Pain Medicine. 4th ed. China. Philadelphia, PA: Lippincott Williams & Wilkins, 2008
15. Chen JY, Ko TL, Wen YR, Wu SC, Chou YH, Yien HW, Kuo CD. Opioid-sparing effects of ketorolac and its correlation with the recovery of postoperative bowel function in colorectal surgery patients: a prospective randomized double-blinded study. Clin J Pain 2009;25:485-9
16. Tramèr M, Moore A, McQuay H. Omitting nitrous oxide in general anaesthesia: meta-analysis of intraoperative awareness and postoperative emesis in randomized controlled trials. Br J Anaesth 1996;76:186-93
17. Unruh AM. Gender variations in clinical pain experience. Pain 1996;65:123-67
18. Nomori H, Kobayashi R, Fuyuno G, Morinaga S, Yashima H. Preoperative respiratory muscle training. Assessment in thoracic surgery patients with special reference to postoperative pulmonary complications. Chest 1994;105:1782-8
19. Manworren RC, Hynan LS. Clinical validation of FLACC: pre-verbal patient pain scale. Pediatr Nurs 2003;29:140-6
20. Cohen MM, Cameron CB, Duncan PG. Pediatric anesthesia morbidity and mortality in the perioperative period. Anesth Analg 1990;70:160-7
21. Kim JY, Lee SJ, Koo BN, Noh SH, Kil HK, Kim HS, Ban SY. The effect of epidural sufentanil in ropivacaine on urinary retention in patients undergoing gastrectomy. Br J Anaesth 2006;97:414-8
22. Broekema AA, Veen A, Fidler V, Gielen MJ, Hennis PJ. Postoperative analgesia with intramuscular morphine at fxed rate versus epidural morphine or sufentanil and bupivacaine in patients undergoing major abdominal surgery. Anesth Analg 1998;87:1346-53
23. Dyer RA, Anderson BJ, Michell WL, Hall JM. Postoperative pain control with a continuous infusion of epidural sufentanil in the intensive care unit: a comparison with epidural morphine. Anesth Analg 1990;71:130-6
24. Valairucha S, Maboonvanon P, Napachoti T, Sirivanasandha B, Suraseranuvongse S. Cost-effectiveness of thoracic patient-controlled epidural analgesia using bupivacaine with fentanyl vs bupivacaine with morphine after thoracotomy and upper abdominal surgery. J Med Assoc Thai 2005;88:921-7
25. Vallejo MC, Edwards RP, Shannon KT, Kaul B, Finegold H, Morrison HL, Ramanathan S. Improved bowel function after gynecological surgery with epidural bupivacaine-fentanyl than bupivacaine-morphine infusion. Can J Anaesth 2000;47:406-11
26. Berti M, Fanelli G, Casati A, Lugani D, Aldegheri G, Torri G. Comparison between epidural infusion of fentanyl/bupiva-caine and morphine/bupivacaine after orthopaedic surgery. Can J Anaesth 1998;45:545-50
27. Gedney JA, Liu EH. Side-effects of epidural infusions of opioid bupivacaine mixtures. Anaesthesia 1998;53:1148-55
28. Tsueda K, Mosca PJ, Heine MF, Loyd GE, Durkis DA, Malkani AL, Hurst HE. Mood during epidural patient-controlled analgesia with morphine or fentanyl. Anesthesiology 1998;88:885-91
29. Saito Y, Uchida H, Kaneko M, Nakatani T, Kosaka Y. Comparison of continuous epidural infusion of morphine/bupivacaine with fentanyl/bupivacaine for postoperative pain relief. Acta Anaesthesiol Scand 1994;38:398-401
30. White MJ, Berghausen EJ, Dumont SW, Tsueda K, Schroeder JA, Vogel RL, Heine MF, Huang KC. Side effects during continuous epidural infusion of morphine and fentanyl. Can J Anaesth 1992;39:576-82
31. Tsui SL, Chan CS, Chan AS, Wong SJ, Lam CS, Jones RD. Postoperative analgesia for oesophageal surgery: a comparison of three analgesic regimens. Anaesth Intensive Care 1991;19:329-37
32. Chrubasik J, Wüst H, Schulte-Mönting J, Thon K, Zindler M. Relative analgesic potency of epidural fentanyl, alfentanil, and morphine in treatment of postoperative pain. Anesthesiology 1988;68:929-33
33. Fischer RL, Lubenow TR, Liceaga A, McCarthy RJ, Ivankovich AD. Comparison of continuous epidural infusion of fentanyl-bupivacaine and morphine-bupivacaine in management of postoperative pain. Anesth Analg 1988;67:559-63
34. Jeon HR, Chae WS, Lee SJ, Lee JH, Cho SH, Kim SH, Jin HC, Lee JS, Kim YI. A comparison of sufentanil and fentanyl for patient-controlled epidural analgesia in arthroplasty. Korean J Anesthesiol 2011;60:41-6
35. Lutti MN, Vieira JL, Eickhoff DR, de Carli D, de Carvalho MA. Patient controlled analgesia with fentanyl or sufentanil in the postoperative period of knee ligament reconstruction: comparative study. Rev Bras Anestesiol 2002;52:166-74
36. Wilhelm AJ, Dieleman HG. Epidural fentanyl and sufentanil for intra-and postoperative analgesia. A randomized, double-blind comparison. Pharm World Sci 1994;16:7-12
37. Cohen S, Amar D, Pantuck CB, Pantuck EJ, Goodman EJ, Widroff JS, Kanas RJ, Brady JA. Postcesarean delivery epi-dural patient-controlled analgesia. Fentanyl or sufentanil? Anesthesiology 1993;78:486-91
38. Geller E, Chrubasik J, Graf R, Chrubasik S, Schulte-Mönting J. A randomized double-blind comparison of epidural sufen-tanil versus intravenous sufentanil or epidural fentanyl analgesia after major abdominal surgery. Anesth Analg 1993;76: 1243-50
39. Yanagidate F, Dohi S. Epidural oxycodone or morphine following gynaecological surgery. Br J Anaesth 2004;93:362-7
40. Backlund M, Lindgren L, Kajimoto Y, Rosenberg PH. Comparison of epidural morphine and oxycodone for pain after abdominal surgery. J Clin Anesth 1997;9:30-5
41. Chaplan SR, Duncan SR, Brodsky JB, Brose WG. Morphine and hydromorphone epidural analgesia. A prospective, randomized comparison. Anesthesiology 1992;77:1090-4
42. Cho JE, Kim JY, Kim JE, Chun DH, Jun NH, Kil HK. Epidural sufentanil provides better analgesia from 24 h after surgery compared with epidural fentanyl in children. Acta Anaesthesiol Scand 2008;52:1360-3
43. Goodarzi M. Comparison of epidural morphine, hydromor-phone and fentanyl for postoperative pain control in children undergoing orthopaedic surgery. Paediatr Anaesth 1999;9:419-22
44. Jaffe RA, Samuels SI. Anesthesiologist's Manual of Surgical Procedures. 4th ed. Philadelphia, PA: Lippincott Williams & Wilkins, 2009
45. Chelly JE, Ben-David B, Williams BA, Kentor ML. Anesthesia and postoperative analgesia: outcomes following orthopedic surgery. Orthopedics 2003;26:s865-71
46. Farrar JT, Berlin JA, Strom BL. Clinically important changes in acute pain outcome measures: a validation study. J Pain Symptom Manage 2003;25:406-11
47. Farrar JT, Portenoy RK, Berlin JA, Kinman JL, Strom BL. Defning the clinically important difference in pain outcome measures. Pain 2000;88:287-94
48. McQuay HJ. Pre-emptive analgesia. Br J Anaesth 1992;69:1-3
49. Ong CK, Lirk P, Seymour RA, Jenkins BJ. The effcacy of preemptive analgesia for acute postoperative pain management: a meta-analysis. Anesth Analg 2005;100:757-73
50. Scott JC, Cooke JE, Stanski DR. Electroencephalographic quan-titation of opioid effect: comparative pharmacodynamics of fentanyl and sufentanil. Anesthesiology 1991;74:34-42
51. Davey J, Turner RM, Clarke MJ, Higgins JP. Characteristics of meta-analyses and their component studies in the Cochrane Database of Systematic Reviews: a cross-sectional, descriptive analysis. BMC Med Res Methodol 2011;11:160
52. Pöpping DM, Elia N, Marret E, Wenk M, Tramèr MR. Opioids added to local anesthetics for single-shot intrathecal anesthesia in patients undergoing minor surgery: a meta-analysis of randomized trials. Pain 2012;153:784-93
53. Gianferrari P, Clara ME, Borghi B, Marzullo A, Voltolina M, De Paolis P, Montone N. [Sufentanil vs morphine combined with ropivacaine for thoracic epidural analgesia in major abdominal surgery]. Minerva Anestesiol 2001;67:155-9
54. Brown AK, Christo PJ, Wu CL. Strategies for postoperative pain management. Best Pract Res Clin Anaesthesiol 2004;18:703-17
55. Pereira J, Lawlor P, Vigano A, Dorgan M, Bruera E. Equianalgesic dose ratios for opioids. A critical review and proposals for long-term dosing. J Pain Symptom Manage 2001;22:672-87