Department of Anaesthesiology, Intensive Care, Emergency Care and Pain Medicine of Turku University Hospital and University of Turku, Turku.
Department of Anaesthesia, Hospital Orton, Invalid Foundation, Helsinki, Finland.
J Pain Res. 2015 Jan 16;8:39-45. doi: 10.2147/JPR.S69511. eCollection 2015.
Quality of life is decreased in patients with hallux valgus deformity, mainly because of pain. Significant improvement is usually achieved by surgery. However, postoperative pain can be moderate to severe for 2-3 days. The aim of the present study was to evaluate the use of transdermal fentanyl for postoperative pain management after forefoot surgery.
Sixty patients undergoing hallux valgus or hallux rigidus surgery were allocated to receive a patch delivering either fentanyl 12 μg/hour or placebo for postoperative pain. The consumption of rescue opioid oxycodone, the primary outcome measure, was evaluated daily until the fourth postoperative day. Total consumption of oxycodone during the study period was also assessed. Pain scores and possible adverse effects were evaluated every 6 hours during the first 24 hours and on the fourth postoperative day.
The use of rescue opioid was low in both groups, the median (range) consumption of oxycodone being 10 (0-50) mg on the day of surgery (no difference between the groups, P=0.31) and 0 (0-35) mg thereafter. The total combined consumption was 10 (0-105) mg in the fentanyl group and 20 (0-70) mg in the placebo group (P=0.23). There were no statistically significant differences in pain scores or adverse effects between the groups.
As a part of multimodal analgesia with ibuprofen and acetaminophen, a patch delivering fentanyl 12 μg/hour did not significantly decrease the consumption of rescue opioid or pain scores after forefoot surgery.
拇外翻畸形患者的生活质量下降，主要是因为疼痛。手术通常能显著改善病情。然而，术后 2-3 天内疼痛可能会中等至重度。本研究旨在评估经皮芬太尼在治疗前足手术后疼痛管理中的应用。
60 例行拇外翻或僵硬拇畸形手术的患者被分配接受 12μg/h 芬太尼贴剂或安慰剂治疗，以评估术后疼痛。每日评估主要结局指标即解救阿片类药物羟考酮的消耗量。还评估了研究期间羟考酮的总消耗量。在最初 24 小时内和术后第 4 天，每 6 小时评估一次疼痛评分和可能的不良反应。
两组患者均较少使用解救阿片类药物，手术当天羟考酮的中位数（范围）消耗量为 10（0-50）mg（两组间无差异，P=0.31），此后为 0（0-35）mg。芬太尼组的总联合消耗量为 10（0-105）mg，安慰剂组为 20（0-70）mg（P=0.23）。两组间疼痛评分或不良反应无统计学差异。
作为布洛芬和对乙酰氨基酚多模式镇痛的一部分，12μg/h 芬太尼贴剂并不能显著减少前足手术后解救阿片类药物的消耗或疼痛评分。
