Effects of low-dose intraoperative fentanyl on postoperative respiratory complication rate: a pre-specified, retrospective analysis.
Adolescent
Adult
Aged
Aged, 80 and over
Analgesics, Opioid
/ administration & dosage
Anesthesia, General
/ methods
Dose-Response Relationship, Drug
Female
Fentanyl
/ administration & dosage
Humans
Intraoperative Period
Male
Middle Aged
Postoperative Complications
/ chemically induced
Registries
Respiration Disorders
/ chemically induced
Retrospective Studies
Young Adult
analgesics
fentanyl
opioid
pneumonia
postoperative complications
respiratory failure
respiratory tract diseases
Journal
British journal of anaesthesia
ISSN: 1471-6771
Titre abrégé: Br J Anaesth
Pays: England
ID NLM: 0372541
Informations de publication
Date de publication:
Jun 2019
Jun 2019
Historique:
received:
07
11
2018
revised:
24
02
2019
accepted:
15
03
2019
pubmed:
16
4
2019
medline:
4
6
2019
entrez:
16
4
2019
Statut:
ppublish
Résumé
Fentanyl is one of the most frequently administered intraoperative drugs and may increase the risk of postoperative respiratory complications (PRCs). We performed a pre-specified analysis of 145 735 adult non-cardiac surgical cases under general anaesthesia. Using multivariable logistic regression, we evaluated the association of intraoperative fentanyl dose and PRCs within 3 days after surgery (defined as reintubation, respiratory failure, pneumonia, pulmonary oedema, or atelectasis). We examined effect modification by patient characteristics, surgical site, and anaesthetics used. PRCs within 3 days after surgery occurred in 18 839 (12.9%) patients. In comparison with high intraoperative fentanyl doses [median: 3.85; inter-quartile range (IQR): 3.42-4.50 μg kg Intraoperative low-dose fentanyl (about 60-120 μg for a 70 kg patient) was associated with lower risk of postoperative respiratory complications compared with both no fentanyl and high-dose fentanyl. Beneficial effects of low-dose fentanyl were magnified in specific patient subgroups. NCT03198208.
Sections du résumé
BACKGROUND
BACKGROUND
Fentanyl is one of the most frequently administered intraoperative drugs and may increase the risk of postoperative respiratory complications (PRCs).
METHODS
METHODS
We performed a pre-specified analysis of 145 735 adult non-cardiac surgical cases under general anaesthesia. Using multivariable logistic regression, we evaluated the association of intraoperative fentanyl dose and PRCs within 3 days after surgery (defined as reintubation, respiratory failure, pneumonia, pulmonary oedema, or atelectasis). We examined effect modification by patient characteristics, surgical site, and anaesthetics used.
RESULTS
RESULTS
PRCs within 3 days after surgery occurred in 18 839 (12.9%) patients. In comparison with high intraoperative fentanyl doses [median: 3.85; inter-quartile range (IQR): 3.42-4.50 μg kg
CONCLUSIONS
CONCLUSIONS
Intraoperative low-dose fentanyl (about 60-120 μg for a 70 kg patient) was associated with lower risk of postoperative respiratory complications compared with both no fentanyl and high-dose fentanyl. Beneficial effects of low-dose fentanyl were magnified in specific patient subgroups.
CLINICAL TRIAL REGISTRATION
BACKGROUND
NCT03198208.
Identifiants
pubmed: 30982564
pii: S0007-0912(19)30218-1
doi: 10.1016/j.bja.2019.03.017
pii:
doi:
Substances chimiques
Analgesics, Opioid
0
Fentanyl
UF599785JZ
Banques de données
ClinicalTrials.gov
['NCT03198208']
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e180-e188Informations de copyright
Copyright © 2019 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.