To Deduce Optimal Fentanyl Infusion Dose for Effective Analgesia with Minimal Side Effects and Maximum Hemodynamic Stability

Abstract

Objective: To deduce optimal fentanyl infusion dose for effective analgesia with minimal side effects and maximum
hemodynamic stability. Material and methods: In our prospective study, we compared three groups (of 30 patients each)
namely group 2, 3, 4 receiving three different doses of fentanyl (20 µg, 30 µg, 40 µg), respectively with control group (Group 1)
receiving conventional analgesics through intramuscular or intravenous route. Effective analgesia was rated on linear visual
analog scale (VAS) with minimum side effects and most stable hemodynamic parameters. Results: The VAS scores, at rest,
were significantly lower for epidural fentanyl groups as compared to control group. Mean blood pressure and pulse rate in
all groups were comparable at all times. The incidence of side effects was similar in the three fentanyl groups as compared
to control group. Conclusion: Fentanyl dose of 40 µg is the optimal epidural dose of background infusion along with patient
on demand analgesia in terms of maximum analgesic efficacy, maximum hemodynamic stability and minimum side effects in
patients undergoing unilateral total knee replacement.